Pharmacy management and administration with bedside real-time medical event data collection

ABSTRACT

Methods and systems for automatically establishing an enhanced electronic health record (EHR) for a patient include an automatic data collection facility that collects data of a medically related event in proximity to a patient upon occurrence of the event. The collected data may include medication administration data such as medication, time of administration, administration of a dosage of medication, reaction data, and the like. The collected data is communicated to a real-time data integration facility that automatically integrates the data with a patient&#39;s electronic health record to establish an enhanced electronic health record.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.13/568,017, filed Aug. 6, 2012 (MILL-0004-U01-V01) which is a divisionalof U.S. patent application Ser. No. 12/765,681, filed Apr. 22, 2010(MILL-0004-U01). U.S. patent application Ser. No. 12/765,681 claimspriority to U.S. Provisional Patent Application Ser. No. 61/171,767,filed Apr. 22, 2009 and to U.S. Provisional Patent Application Ser. No.61/315,775 filed Mar. 19, 2010.

Each of the above applications is hereby incorporated by reference inits entirety.

BACKGROUND OF THE INVENTION

Field

This invention relates to systems, methods, and devices for automatedordering, dispensing, reporting, and billing of medication and theassociated reporting and documentation of the administration ofmedication.

Description of the Related Art

A common scenario with respect to the ordering, dispensing, reporting,billing and documentation of a prescribed medication begins with aphysician's handwritten order. This handwritten order must betransmitted to the pharmacy; typically the order is faxed. In otherinstances, the order can be entered into an electronic computerizedphysician order entry system “CPOE”. A person at the pharmacy reviewsthe physician order and enters the order into the pharmacy's ordermanagement system. This is also the case even where the order is anelectronic order such as like one entered into a CPOE system. That is,some sort of manual data entry step takes place to get the order intothe pharmacy's order management system. After the data is manuallyentered, the drug interaction and allergy verification takes place,which may be performed by a software application which is part of theCPOE system or the pharmacy's order management system. Once the druginteraction and allergy verification step is complete, the pharmacistapproves the order, which allows it to be filled, and then the drug isdispensed and packaged.

A common way to dispense medications is in a 30 day or a 7 day supply.In long-term care and other institutional-like settings, for example,dispensed medications are delivered to the facility where they will beadministered to the patient 150. If there is a change to a patient'sprescription during the 30 day cycle, for example, for which themedication was dispensed, then the unused medication must be returned ordestroyed. This adds an additional burden to facilities in that theymust adhere to proper destruction procedures, and document themaccordingly. Dealing with ordered medications which have been dispensedand delivered, but which are no longer current, places a heavy financialburden on payers, (e.g. health care facilities, insurance companies,patients, and the like), and on the pharmacies because many times theyare paying for a supply of medications that the patient never uses.

Regarding the administration of the medication, regulations require thatthe administration of the medication must be documented with a certaindegree of specificity and accuracy. Regulations also require a review ofsuch documentation, for example, on a periodic basis. The administrationprocess is further complicated by brand and generic drugs and multiplebrands within the generic medications. Accurate maintenance of therecords requires the prescriber, dispensing pharmacy, and theadministering system and personnel to be in sync with respect to theidentification of the medications.

Patient symptom gathering is another area of concern with respect to theaccuracy and validity of common practices. At patient touch points,clinicians are often required to listen to a patient describe symptomsand enter those symptoms in a structured language that allows medicalpersonnel to understand how the clinician views the patient report ofsymptoms. This process naturally introduces misinformation, clinicianbias, information gaps, and other factors that contribute to therecorded symptom being different than that reported by the patient.Patients generally report symptoms (e.g. side effects) related to anadministration of a medication sooner and with more specificity than isoften reported in clinical studies, and the like.

During a patient interview (e.g. office visit), symptoms may not alwaysbe reported because clinicians and patients are distracted from thisactivity by reviewing test results and the like. Ensuring that accurate,patient generated symptom reports are captured at least with eachpatient touch point may be a critical deficiency in medical practice.Also, in a report authored by a patient, the symptoms tend to be moreaccurately described than when the same patient is interviewed (orally)by a clinician. Ensuring accurate and timely side effect reporting maybe critical to proper and effective medication management.

It is therefore an object of the invention to address the shortcomingsdescribed above, along with others that are apparent in this disclosure.

SUMMARY OF THE INVENTION

In embodiments, methods and systems for automatically establishing anenhanced electronic health record (EHR) for a patient in accordance withvarious embodiments of the present invention may be provided. Inembodiments, methods and systems may include an automatic datacollection facility and a real-time data integration facility. Inembodiments, the automatic data collection facility may collect data ofa medically related event in proximity to a patient upon occurrence ofthe event. The data of the medically-related event may includemedication administration data such as medication, time ofadministration, administration of a dosage of medication, reaction data,and the like. In embodiments, the real-time data integration facilitymay be in electronic communication with the automatic data collectionfacility. The real-time data integration facility may automaticallyintegrate the data of a medically-related event with a patient's EHR toestablish the enhanced EHR.

In embodiments, the automatic data collection facility may be a machinereader, a reader device, and the like. The machine reader may also be abar code reader. In embodiments, the reader device may be in electroniccommunication with a medication administration facility. The readerdevice may read electronically readable information on packaging of thedosage of medication. In embodiments, a healthcare-related dashboard maybe updated in real-time and contemporaneously with establishing theenhanced EHR.

In embodiments, the methods and systems for automatically establishingan enhanced electronic health record (EHR) for the patient may includean input facility adapted to prompt a user to input additional data ofthe medically-related event.

In embodiments, the enhanced EHR may include prescription managementdata for a medication that may be identifiable by the medicationadministration data. Further, the enhanced EHR data may represent aprescription for the medication and medication delivery data, acaregiver treatment outcome data, real-time collected vitals pre andpost administration, outcome prediction and variance from prediction,historical data, facility admission data, and the like.

In embodiments, methods and systems for automatically establishing anenhanced electronic health record (EHR) for a patient in accordance withvarious embodiments of the present invention may be provided. Inembodiments, methods and systems may include an automatic datacollection facility and a real-time data integration facility. Theautomatic data collection facility may collect data of amedically-related event in proximity to a patient upon occurrence of theevent. The data of the medically-related event may include medicationadministration data, such as medication, time of administration,administration of a dosage of medication, reaction data, and the like.Further, the real-time data integration facility may automaticallyintegrate in real-time the data of a medically-related event with apatient's EHR to establish the enhanced EHR.

In embodiments, the automatic data collection facility may be a machinereader, a reader device, and the like. The machine reader may also be abar code reader. In embodiments, the reader device may be in electroniccommunication with a medication administration facility. Further, thedata collection may include reading electronically readable informationon a packaging of the dosage of medication with the reader device.

In embodiments, the methods and systems for automatically establishingan enhanced electronic health record (EHR) for the patient may includeprompting a user to input additional data of the medically-related eventwith a user interface associated with the data collection facility.

In embodiments, a healthcare-related dashboard with a portion of themedically-related event data may be updated in real-time andcontemporaneously with establishing the enhanced EHR.

In embodiments, methods and systems for automatically establishing anenhanced electronic health record (EHR) for a patient in accordance withvarious embodiments of the present invention may be provided. Inembodiments, methods and systems may include collecting data of amedically-related event with an automatic data collection facility inproximity to a patient upon occurrence of the event. The data of themedically-related event may include raw medication administration data,such as medication, time of administration, administration of a dosageof medication, reaction data, and the like. The raw medication data mayalso include a bar code. In embodiments, the raw medicationadministration data collected by the automatic data collection facilitymay be transformed with a processor into a format that may be suitablefor use in an enhanced electronic healthcare database record. Further,the real-data of a medically-related event may be integrated inreal-time with a patient's EHR to establish the enhanced EHR.

In embodiments, the automatic data collection facility may be a machinereader, a reader device, and the like. The machine reader may also be abar code reader. In embodiments, the reader device may be in electroniccommunication with a medication administration facility. Further, thedata collection may include reading electronically readable informationon a packaging of the dosage of medication with the reader device.

In embodiments, the methods and systems for automatically establishingan enhanced electronic health record (EHR) for the patient may includeprompting a user to input additional data of the medically-related eventinto a user interface associated with the data collection facility.

In embodiments, a healthcare-related dashboard with a portion of themedically-related event data may be updated in real-time andcontemporaneously with establishing the enhanced EHR.

In embodiments, methods and systems for automatically maintaining anenhanced electronic health record (EHR) in accordance with variousembodiments of the present invention may be provided. In embodiments,methods and systems may include an automatic data collection facilityand a real-time data integration facility. In embodiments, the automaticdata collection facility may collect data of a healthcare-related eventin proximity to a patient upon occurrence of the event. The data of thehealthcare-related event may include medication administration data,such as medication, time of administration, administration of a dosageof medication, reaction data, and the like. In embodiments, thereal-time data integration facility may be in electronic communicationwith the automatic data collection facility. The real-time dataintegration facility may automatically integrate the data of ahealthcare-related event with a patient's EHR to maintain the enhancedEHR.

In embodiments, the automatic data collection facility may be a machinereader, a reader device, and the like. The machine reader may also be abar code reader. In embodiments, the reader device may be in electroniccommunication with a medication administration facility. The readerdevice may read electronically readable information on packaging of thedosage of medication.

In embodiments, the methods and systems for automatically establishingan enhanced electronic health record (EHR) for the patient may includean input facility adapted to prompt a user to input additional data ofthe health-related event. In embodiments, a healthcare-related dashboardthat may be updated in real-time and contemporaneously with establishingthe enhanced EHR.

In embodiments, the enhanced EHR may include prescription managementdata for a medication that may be identifiable by the medicationadministration data. Further, the enhanced EHR data may represent aprescription for the medication and medication delivery data, acaregiver treatment outcome data, real-time collected vitals pre andpost administration, outcome prediction and variance from prediction,historical data, facility admission data, and the like.

In embodiments, methods and systems for automatically maintaining anenhanced electronic health record (EHR) for a patient in accordance withvarious embodiments of the present invention may be provided. Inembodiments, methods and systems may collect data of ahealthcare-related event with an automatic data collection facility inproximity to a patient upon occurrence of the event. The data of thehealthcare-related event may include medication administration data suchas medication, time of administration, administration of a dosage ofmedication, reaction data, and the like. In embodiments, the data of ahealthcare-related event may be integrated in real-time with a patient'sEHR to maintain the enhanced EHR.

In embodiments, the automatic data collection facility may be a machinereader, a reader device, and the like. The machine reader may also be abar code reader. In embodiments, the reader device may be in electroniccommunication with a medication administration facility. The readerdevice may read electronically-readable information on packaging of thedosage of medication.

In embodiments, the methods and systems for automatically establishingan enhanced electronic health record (EHR) for the patient may includeprompting a user to input additional data of the healthcare-relatedevent. In embodiments, a healthcare-related dashboard with a portion ofthe healthcare-related event data may be updated in real-time andcontemporaneously with establishing the enhanced EHR.

In embodiments, methods and systems for automatically maintaining anenhanced electronic health record (EHR) for a patient in accordance withvarious embodiments of the present invention may be provided. Inembodiments, methods and systems may collect data of ahealthcare-related event with an automatic data collection facility inproximity to a patient upon occurrence of the event. The data of thehealthcare-related event may include raw medication administration data,such as medication, time of administration, administration of a dosageof medication, reaction data, and the like. The raw medication data mayalso include a bar code. In embodiments, the raw medicationadministration data collected by the automatic data collection facilitymay be transformed with a processor into a format that may be suitablefor use in an enhanced electronic healthcare database record. Further,the data of a healthcare-related event may be integrated in real-timewith a patient's EHR to maintain the enhanced EHR.

In embodiments, the automatic data collection facility may be a machinereader, a reader device, and the like. The machine reader may also be abar code reader. In embodiments, the reader device may be in electroniccommunication with a medication administration facility. In embodiments,the data collection may include reading electronically readableinformation on a packaging of the dosage of medication with the readerdevice.

In embodiments, the methods and systems for automatically establishingan enhanced electronic health record (EHR) for the patient may includeprompting a user to input additional data of the healthcare-relatedevent into a user interface with the data collection facility. Inembodiments, a healthcare-related dashboard with a portion of thehealthcare-related event data may be updated in real-time andcontemporaneously with establishing the enhanced EHR.

In embodiments, methods and systems for automatically establishing anenhanced electronic health record (EHR) for a patient in accordance withvarious embodiments of the present invention may be provided. Inembodiments, methods and systems may collect data of a medically-relatedevent with an automatic data collection facility in proximity to apatient upon occurrence of the event. The data of the medically-relatedevent may include medication administration data and another type ofdata of the medically-related event. In embodiments, the medicationadministration data may be medication, time of administration,administration of a dosage of medication, reaction data, and the like.In embodiments, the other type of the medically-related event mayinclude patient health condition data, patient physical activity data,patient treatment data, patient oral consumption data; patient visitordata, patient outcome data, patient psychological data, and the like. Inembodiments, the patient health condition data may include patient vitalsigns, patient blood chemistry results, and the like. In embodiments,the patient physical activity data may include patient position andmovement facilitated by a caregiver, patient sleep data, and the like.In embodiments, the patient treatment data may include bathing,dressing, wound care, bed position adjustment, physical therapy,psychotherapy, patient position adjustment, and the like. In embodimentsthe patient oral consumption data may represent foods prepared for thepatient and foods consumed by the patient, fluids consumed by thepatient, non-prescription medications consumed by the patient, and thelike. In embodiments, the patient psychological data may be collected byobservation of the patient by a caregiver observing the patient

In embodiments, methods and systems for automatically maintaining anenhanced electronic health record (EHR) for a patient in accordance withvarious embodiments of the present invention may be provided. Inembodiments, methods and systems may include an automatic datacollection facility and a real-time data integration facility. Inembodiments, the automatic data collection facility may collect data ofa medically-related event in proximity to a patient upon occurrence ofthe event. The data of the medically-related event may includemedication administration data that may include patient identificationdata that may be collected from a medication container contemporaneouslywith the medically-related event. In embodiments, the real-time dataintegration facility may be in electronic communication with theautomatic data collection facility. The real-time data integrationfacility may automatically integrate the data of a medically-relatedevent with a patient's EHR to maintain the enhanced EHR.

In embodiments, methods and systems for automatically maintaining anenhanced electronic health record (EHR) for a patient in accordance withvarious embodiments of the present invention may be provided. Inembodiments, methods and systems may include collecting data of amedically-related event in proximity to a patient upon occurrence of theevent with an automatic data collection facility. The data of themedically-related event may include medication administration data thatmay include patient identification data that may be collected from amedication container contemporaneously with the medically-related event.In embodiments, the data of a medically-related event may be integratedin real-time automatically with a patient's EHR to maintain the enhancedEHR.

In embodiments, methods and systems for automatically maintaining anenhanced electronic health record (EHR) for a patient in accordance withvarious embodiments of the present invention may be provided. Inembodiments, methods and systems may collect data of a medically-relatedevent with an automatic data collection facility in proximity to apatient upon occurrence of the event. The data of the healthcare-relatedevent may include raw medication administration data. The raw medicationadministration data may include patient identification data that may becollected from a medication container contemporaneously with themedically-related event. In embodiments, the raw medicationadministration data collected by the automatic data collection facilitymay be transformed with a processor into a format that may be suitablefor use in an enhanced electronic healthcare database record. Further,the data of a medically-related event may be integrated in real-timeautomatically with a patient's EHR to maintain the enhanced EHR.

In embodiments, methods and systems for automatically maintaining anenhanced electronic health record (EHR) for a patient in accordance withvarious embodiments of the present invention may be provided. Inembodiments, methods and systems may include an automatic datacollection facility and a real-time data integration facility. Inembodiments, the automatic data collection facility may collect data ofa medically-related event in proximity to a patient upon occurrence ofthe event. The data of the medically-related event may includemedication administration data. In embodiments, the data of themedically-related event may include data for a medication that wasprescribed but not administered during the occurrence of the event. Inembodiments, the real-time data integration facility may be inelectronic communication with the automatic data collection facility.The real-time data integration facility may automatically integrate thedata of a medically-related event with a patient's EHR to establish theenhanced EHR.

In embodiments, methods and systems for automatically maintaining anenhanced electronic health record (EHR) for a patient in accordance withvarious embodiments of the present invention may be provided. Inembodiments, methods and systems may collect data of a medically-relatedevent with an automatic data collection facility in proximity to apatient upon occurrence of the event. The data of the medically-relatedevent may include medication administration data. In embodiments, thedata of the medically-related event may include data for a medicationthat was prescribed but not administered during the occurrence of theevent. Further, the data of a medically-related event may be integratedin real-time automatically with a patient's EHR to maintain the enhancedEHR.

In embodiments, methods and systems for automatically maintaining anenhanced electronic health record (EHR) for a patient in accordance withvarious embodiments of the present invention may be provided. Inembodiments, methods and systems may collect data of a medically-relatedevent with an automatic data collection facility in proximity to apatient upon occurrence of the event. In embodiments, themedically-related event may be a medication administration event.Further, the data of the medically-related event may include a raw datafor a medication that was prescribed but not administered during theoccurrence of the event. In embodiments, the raw data for a medicationcollected by the automatic data collection facility may be transformedwith a processor into a format that may be suitable for use in anenhanced electronic healthcare database record. Further, the data of amedically-related event may be integrated in real-time automaticallywith a patient's EHR to maintain the enhanced EHR.

In embodiments, methods and systems for maintaining a health informationdashboard in accordance with various embodiments of the presentinvention may be provided. In embodiments, methods and systems mayinclude an automatic data collection facility, a real-time dataintegration facility, and a user interface. In embodiments, theautomatic data collection facility may collect data of amedically-related event in proximity to a patient upon the occurrence ofthe event. The data of the medically-related event may includemedication administration data. In embodiments, the real-time dataintegration facility in electronic communication with the automatic datacollection facility may automatically integrate the data of amedically-related event into a data repository. Further, the userinterface may display data from the data repository. In embodiments, thedisplayed data may facilitate management of health care administration.

In embodiments, the user interface display may be updated with the dataof a medically-related event contemporaneously with integrating the dataof a medically-related event into a data repository.

In embodiments, the data repository may be an enhanced electronic healthrecord of a patient. In embodiments, the data from the data repositorymay include patient attribute data, patient's prescription data,patient's validated prescription data, patient's prescription historydata, and prescription substitution data. In embodiments, the datarepository may relate to the time of medication administration,frequency of administration of the medication, dosage of medicationadministered to the patient, medication that was prescribed but notadministered, and outcome data. The patient attribute data may includehealth condition data, patient physical activity data, patient treatmentdata, patient outcome data, and patient psychological data. Inembodiments, the outcome data may include a patient's response to themedication, measure of the patient's health condition, improvement orworsening of the patient's health condition, improvement or worsening ofa symptom, onset of new symptoms, degree of pain, degree of fatigue,physical functioning, emotional distress and social role participation,and the like.

In embodiments, the management of health care administration may includemanagement of health care administration of a facility, management ofhealth care administration of care planning for one or more patients,management of health care administration of facility planning,management of health care administration of insurance planning,management of health care administration of prescription writing,management of health care administration of prescription management,management of health care administration of pharma-related planning,management of health care administration of regulatory compliance,management of health care administration of use of third-partyhealthcare data management facilities, management of health careadministration of medication administration, and the like.

In embodiments, methods and systems for maintaining a health informationdashboard in accordance with various embodiments of the presentinvention may be provided. The methods and systems may includecollecting data of a medically-related event with an automatic datacollection facility in proximity to a patient upon the occurrence of theevent. In embodiments, the data of a medically-related event may includemedication administration data. In embodiments, the data of themedically-related event may be integrated in real-time automatically into a data repository. Further, dashboard of a user interface data may bedisplayed from the data repository, the displayed data facilitatingmanagement of health care administration.

In embodiments, methods and systems for maintaining a health informationdashboard in accordance with various embodiments of the presentinvention may be provided. The methods and systems may includecollecting data of a medically-related event with an automatic datacollection facility in proximity to a patient upon the occurrence of theevent. In embodiments, the data of medically-related event may includeraw medication administration data. In embodiments, the data of themedically-related event may be integrated in real-time automatically into a data repository. Further, dashboard of a user interface data may bedisplayed from the data repository, the displayed data facilitatingmanagement of health care administration.

In embodiments, methods and systems including a dashboard system tomanage the prescribing and administration of medication in accordancewith various embodiments of the present invention may be provided. Inembodiments, a medication administrator records (MAR) facility may beconfigured to access a database having information from a reportingsource therein. The reporting source may include an automatic datacollection facility for collecting data of a medically-related event inproximity to a patient upon the occurrence of the event. The data ofmedically-related event may include medication administration data.Further, a user selectable dashboard definer may be configured toprovide user selectable options for defining the information from theMAR facility to be presented in a report at a dashboard. In embodiments,a display definer may be configured to operate in conjunction with theuser selectable dashboard definer to define the format in which thereport from the MAR facility is to be presented at a dashboard.

In embodiments, the MAR facility may be configured to determine anordered medication for a patient and medication may be administered to apatient covered by the patient's insurance. The aggregate covered andnon-covered medications may be determined into sets. Further, the reportmay be generated, in real-time, regarding the sets. In embodiments, thecommunication with the reporting source may be real-time. Inembodiments, the dashboard may generate a display based on thecontinuously received data. In embodiments, the display may featureanalysis and report tools.

In embodiments, methods and systems for predicting a health-relatedoutcome of a patient with a health condition in accordance with variousembodiments of the present invention may be provided. The methods andsystems may include an automatic data collection facility, real-timedata integration facility, a prediction facility, and the like. Inembodiments, the automatic data collection facility may collect data ofa medically-related event in proximity to a patient upon the occurrenceof the event. The data of the medically-related event may includeautomatically collected medication administration data and outcome data.In embodiments, the real-time data integration facility in electroniccommunication with the automatic data collection facility mayautomatically integrate the data of a medically-related event into adata repository. In embodiments, the prediction facility in electroniccommunication with the data repository may utilize the data of amedically-related event for predicting the health-related outcome.

In embodiments, the outcome data may include the patient's response tothe medication, a measure of the patient's health condition, and thelike. In embodiments, the outcome data may relate to an improvement orworsening of the patient's health condition, an improvement or worseningof a symptom associated with the patient's health condition, onset ofnew symptoms associated with the patient's health condition, degree ofpain associated with the patient, degree of fatigue associated with thepatient, physical functioning associated with the patient, emotionaldistress associated with the patient, social role participationassociated with the patient, patient's response to the medication,measure of the patient's health condition, an improvement or worseningof the patient's health condition, and the like.

In embodiments, the automatic data collection may collect data from amedication container contemporaneously with the medically-related event.The data of a medically-related event may include data for a medicationthat was prescribed but not administered during the occurrence of theevent.

In embodiments, an input facility may be present for entering other dataof the medically-related event. In embodiments, the other data mayinclude patient health condition data patient, physical activity data,patient treatment data, patient oral consumption data, patient visitordata, patient psychological data, caregiver observations, and the like.

In embodiments, the prediction of the health-related outcome may bebased on medically-related event data for a plurality of patients in thedata repository. The data repository may include a plurality ofreal-time electronically updated patient enhanced electronic healthrecords. The data repository may be an enhanced electronic health recordof the patient. Further, the data repository may also include individualpatient outcome data collected in real-time from a plurality ofindividual patients.

In embodiments, the prediction facility may be for collecting andorganizing the outcome data for facilitating clinical outcomeprediction, server executing machine learning software, an analyticworkbench for drawing inferences as to whether certain data in the datarepository has statistical significance in the outcome data.

In embodiments, the prediction facility may use statistical analysistechniques selected from the list containing regression analysis,iterative analysis, complex modeling, multivariable analytics, Analysisof Variance (ANOVA), Chi-square test, Correlation, Factor analysis,Mann-Whitney U, Mean square weighted deviation (MSWD), Pearsonproduct-moment correlation coefficient, Regression analysis, Spearman'srank correlation coefficient, Student's t-test, Time series analysis,Bootstrap & Jackknife Resampling, Statistical classification,Statistical surveys, Structured data analysis (statistics), Survivalanalysis, Multivariate discriminant analysis, Linear discriminantanalysis, Cluster analysis, and Principal component analysis.

In embodiments, predicting the health-related outcome may includeweighting the outcome data. Further, weighting the outcome data may bebased on financial data associated with a medication identifiable by themedication administration data. In embodiments, based on the predictedhealth-related outcome long-term care plan for the patient may bemaintained, prescription management may be facilitated, prescriptionmanagement business rules may be updated, a pharmaceutical-related planmay be updated, management of regulatory compliance may be facilitated,prescription writing based may be facilitated, facilitating managementof insurance planning, facilitating management of facility planning,facilitating management of care planning for a plurality of patients,and facilitating health care administration.

In embodiments, methods and systems for predicting a health-relatedoutcome of a patient with a health condition in accordance with variousembodiments of the present invention may be provided. In embodiments,the data of a medically-related event may be collected with an automaticdata collection facility in proximity to a patient upon the occurrenceof the event. In embodiments, the data of the medically-related eventmay include automatically collected medication administration data andevent outcome data. Further, the data of the medically-related event maybe integrated in real-time automatically into a data repository.Additionally, the data of the medically-related event may be utilizedfor predicting the health-related outcome. In embodiments, collectingdata of a medically-related event may include collecting data from amedication container contemporaneously with the medically-related event.The data of a medically-related event may include data for a medicationthat was prescribed, but not administered during the occurrence of theevent. In embodiments, the outcome data is the patient's response to themedication, a measure of the patient's health condition, and animprovement or worsening of the patient's health condition.

In embodiments, methods and systems for predicting a health-relatedoutcome of a patient with a health condition in accordance with variousembodiments of the present invention may be provided. In embodiments,the data of a medically-related event may be collected with an automaticdata collection facility in proximity to a patient upon the occurrenceof the event. The data of the medically-related event may includeautomatically collected raw medication administration data and raw eventoutcome data. The raw medication administration data and raw eventoutcome data collected by the automatic data collection facility may betransformed with a processor into a format suitable for use in a medicalinformation data repository. Further, the data of the medically-relatedevent may be integrated in real-time automatically into the datarepository. Lastly, the data of the medically-related event may beutilized for predicting the health-related outcome.

In embodiments, methods and systems for managing administration,billing, and filling orders for medication may be provided. Inembodiments, the methods and systems may include a medicationadministration facility, a medication order and billing facility, areporting interface, an automatic data collection facility, a real-timedata integration facility, and the like. In embodiments, the medicationadministration facility may automatically receive data related to actualadministration of medications. In embodiments, the medication order andbilling facility may store data related to orders and cost of theadministered medication. In embodiments, the medication administrationfacility, and the medication order and billing facility may be a two-waycommunication in real-time. Further, the medication administrationfacility and the medication order and billing facility may be inreal-time communication with the reporting interface.

In embodiments, the data related to actual administration of medicationsmay be automatically received from an automatic data collection facilityfor collecting medication administration data in proximity to a patientupon the occurrence of the administration.

In embodiments, the real-time data integration facility may be inelectronic communication with the medication administration facility.The real-time data integration facility may automatically integrate thedata related to actual administration of medications with a patient'selectronic health record to establish the enhanced electronic healthrecord.

In embodiments, the real-time data integration facility may be a two-waycommunication in real-time with the medication order and billingfacility and the medication administration facility, and in real-timecommunication with the reporting interface.

These and other systems, methods, objects, features, and advantages ofthe present invention will be apparent to those skilled in the art fromthe following detailed description of the preferred embodiment and thedrawings. All documents mentioned herein are hereby incorporated intheir entirety by reference.

BRIEF DESCRIPTION OF THE FIGURES

The invention and the following detailed description of certainembodiments thereof may be understood by reference to the followingfigures:

FIG. 1 depicts a block diagram of a healthcare and pharmacy datamanagement and administration method and system (HPDMA);

FIG. 2 depicts a block diagram of a portion of the HPDMA;

FIG. 3 depicts a block diagram of another portion of the HPDMA;

FIG. 4 depicts a flow chart and exemplary structural elements of abed-side process of establishing an enhanced electronic health record;

FIG. 5 depicts a flow chart and exemplary structural elements of abed-side process of maintaining an enhanced electronic health record;

FIG. 6 depicts a flow chart and exemplary structural elements of abed-side process of collecting patient health condition data toestablish a enhanced electronic health record;

FIG. 7 depicts a flow chart and exemplary structural elements of abed-side process of collecting patient psychological data associatedwith a medically-related event to establish a enhanced electronic healthrecord;

FIG. 8 depicts a flow chart and exemplary structural elements of abed-side process of identifying medication based on an enhancedelectronic health record;

FIG. 9 depicts a flow chart and exemplary structural elements of abed-side process of collecting medication information in associationwith a medically-related event;

FIG. 10 depicts a flow chart and exemplary structural elements of abed-side process of collecting non-administered medication informationin association with a medically-related event;

FIG. 11 depicts a flow chart and exemplary structural elements of abed-side process of medically-related event data collection forreal-time updating of a dashboard;

FIG. 12 depicts a flow chart and exemplary structural elements of aprocess of configuring a dashboard;

FIG. 13 depicts a flow chart and exemplary structural elements of aprocess of predicting a medical event outcome;

FIG. 14 depicts a flow chart and exemplary structural elements of aprocess of using medical event predicted outcomes in a medical-relateddashboard; and

FIG. 15 depicts a medicine administration dashboard.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT(S)

FIG. 1 is a block diagram showing an overview of a healthcare andpharmacy data management and administration method and system (HPDMA)100 that may facilitate ordering, dispensing, reporting, billing,planning, outcome collection, outcome analysis and prediction, thirdparty data and services integration, real-time data collection andtransfer, user interfaces, documentation, and the like related to aprescription, such as a prescribed medication, and to variouspatient-related events and outcomes, such as relating to a patient whois taking a prescribed medication. Referring to FIG. 1, variousfacilities may be included in the HPDMA 100 including a medicalprescription (RX) validation and selection facility 102 (alternativelyreferred to as a medication management facility), a dispensing andmarking facility 104, an RX delivery facility 108 (note items 102, 104,and 108 may collectively be referred to as a prescription managementfacility 106), a prescription administration facility 110 (also referredto herein as a medication administration facility), a patient attributesand events facility 112, an outcome events facility 114, an EnhancedElectronic Health Record (E-EHR)/an Enhanced Electronic Medical Record(E-EMR) facility 118, an outcome facility 120, an existing medicalrecord facility 122, an outcome database facility 124, an outcomeanalytics facility 128, a rehabilitation and Long Term Care (“LTC”)facility 130, a third party integration facility 132, labs and imagingfacility 134, an insurance and payments facility 138, a regulatoryfacility 140, a pharmaceutical (pharma) planning facility 142, afacility planning facility 144, an insurance planning facility 148, adashboard facility 150, a care planning facility 152, a prescribingfacility 154 and a third party data facility 158. Each facility mayindividually be communicatively connected together through a network,such as the Internet, a proprietary network, a virtual private network,or the like, to facilitate real-time data capture and communication ofdata among the facilities. Although FIG. 1 depicts the facilitiesdescribed above and elsewhere herein, HPDMA 100 may not be limited toonly these facilities and may include other medical-related facilities,such as other data facilities, care facilities, prescription facilities,communication facilities, and the like.

The prescribing facility 154 may allow a doctor, physician, nurse,pharmacist, or a healthcare specialist to enter an order for aprescription of a medication or other medical care items for a patient.The HPDMA 100 may apply a plurality of identification methods touniquely identify, record, and document details of person entering theorders. The prescribing facility 154 may be communicatively coupled inreal-time to a backbone network 103. The backbone network 103 may be anetwork that may be communicatively coupled to other facilities of theHPDMA 100 and elsewhere and may carry medical data being communicatedamong the facilities, such as real-time medical data event packets,files, or streams. The exemplary medical event data being carried overthe backbone 103 may include information from any of the facilitiesdepicted in FIG. 1 including, without limitation prescribing units, careplanning facilities, laboratories and imaging centers, insurance andpayments units, rehabilitation and LTC facilities, electronic medicalrecord repositories, dashboards and databases, third-party sites,healthcare facilities, and the like. In an exemplary case, the backbonenetwork 103 may be the Internet, an intranet, a Wide Area Network, aLocal Area Network, a wireless network, a personal area network, avirtual private network, or any other type of wired, wireless, orlogical network including ad hoc, peer-to-peer, hub-and-spoke, tree,ring, serial, infrastructure-type protocols, and the like. The backbonenetwork 103 may also facilitate secure communication among differentfacilities of the HPDMA 100, using firewalls, password protection,anti-virus protection, packet inspection, spam filtering, and othersecurity facilities.

Further, the prescribing facility 154 may obtain patient information viathe backbone network 103. The information may include the medicalhistory, clinical outcomes, allergic reactions to certain types of drugsand similar kind of information related to the patient. The prescribingfacility 154 may also allow the healthcare specialist to prescribemedication, such as through an electronic order entry facility (notshown in FIG. 1). In an example, the electronic order entry facility maycomprise an interface for aiding a healthcare specialist to prescribethe medication or treatment for the patient. The prescribing facility154 may present the obtained patient information to the healthcarespecialist to help facilitate prescribing appropriate medication ortreatment for the patient. Once the healthcare specialist enters theprescription of the patient in the electronic order entry facility, theprescribing facility 154 may communicate the prescription to thebackbone network 103 or may sent it directly to the prescriptionmanagement facility 106, and in embodiments directly to the prescriptionvalidation/selection facility 102 therein. This communication may bedone in real-time as an event. Further, the prescription may be madeavailable to all other facilities of the HPDMA 100 via the backbonenetwork 103.

In an embodiment of the invention, the prescription from theprescription facility 154 may be raw prescription data associated withthe patient. The raw prescription data may not be in a format that maybe integrated with the E-EHR/E-EMR facility 118. The prescriptionfacility 154 may include a computer (not shown in the FIG. 1) that maytransform the raw prescription data to a format such that it may beintegrated with the patient's EHR in the E-EHR/E-EMR facility 118.

The prescription may be received by an RX validation and selectionfacility 102 either directly from the prescribing facility 154 or overthe backbone network 103 to which the RX validation and selectionfacility 102 may be communicatively coupled. The RX validation andselection facility 102 may be configured to receive/send real-time eventtracking data with other patient medical related facilities. Further,the RX validation and selection facility 102 may also obtain informationregarding the patient, including the past medical history of thepatient, treatment outcomes for the patient (from past or currenttreatments), allergic reactions to certain types of drugs and similarkinds of information. The RX validation and selection facility 102 maythus embody various features to ensure improved probability of selectingand delivering the appropriate medication to the patient, such asmodules for identifying patient allergies or sensitivities, modules foridentifying potential interactions among medications prescribed orproposed to be prescribed, and modules that use information or insightsderived from the outcome module 120, such as to propose medications thathave produced favorable outcomes in other similar patients.

In an exemplary case, the RX validation and selection facility 102 maybe a pharmacy facility and may include the services of a pharmacist tovalidate the medical prescription of the patient. In another exemplarycase, the pharmacist may be provided with a graphical user interface forperforming validation of the medical prescription. Further, in such aninterface, a user may utilize various buttons, list boxes, and textboxes for viewing, entering and managing data, such as patient data,medication data, outcome data, and order entry data. In order to confirmthe validity of data entered, the software underlying the graphical userinterface may validate the entered data, such as for proper format andfor the absence of various problems, such as unfavorable interactionswith other medications, conflict with patient allergy information,indication of a likely unfavorable outcome, deviation for standards(such as in units prescribed, frequency of prescription, or the like).

By way of example, once the RX validation and selection facility 102 hasreceived the medical prescription and the other details and informationabout the patient, the RX validation and selection facility 102 mayverify formulary compliance, determine drug allergy informationassociated with the prescribed drugs, and confirm the drug interactioninformation associated with the prescribed medication. The RX validationand selection facility 102 may issue alerts or warnings to thepharmacist, the healthcare specialist entering the medication order on apatient-by-patient basis to provide an opportunity for the prescriber toconsider the prescription in light of these warnings and potentiallymake adjustments in the prescription before the RX validation andselection facility 102 accepts the order into its processing facilities.After these activities have been accomplished and after reviewing allthe relevant patient information, a pharmacist associated with the RXvalidation and selection facility 102 may validate the patient medicalprescription. This pharmacist-based validation may be done as a manualconfirmation that follows a series of automated validation steps asdescribed herein. The RX validation and selection facility 102 maycommunicate the validated prescription of the patient to otherfacilities of the HPDMA 100 via the backbone network 103.

In an embodiment of the invention, the validated prescription from theRX validation and selection facility 102 may be raw validatedprescription data associated with the patient. The raw validatedprescription data may not be in a format that may be integrated with theE-EHR/E-EMR facility 118. The RX validation and selection facility 102may include a computer (not shown in the FIG. 1) that may transform theraw validated prescription data to a format such that it may beintegrated with the patient's EHR in the E-EHR/E-EMR facility 118.

After the prescription has been validated, the validated prescriptionmay be received by the dispensing and marking facility 104. Thevalidated prescription may be received with associated informationregarding formulary compliance, drug allergy information, druginteraction information, brand versus generic prescription requirements,non-active ingredients of generic medications, costs and inventoryinformation related to the medication, and the like. The information maybe provided via a user interface which is accessible on a work stationor maybe sourced from other facilities or data sources, such as throughthe backbone 103. The dispensing and marking facility 104 may receivethe validated prescription and the associated information in real-timefrom the communicatively coupled back bone network 103. In an exemplarycase, the dispensing and marking facility 104 may be a pharmacy or mayinclude automated dispensing and labeling machines within a pharmacy.Although, as with all facilities described herein, this facility orportions thereof may be coded instructions executed by variousprocessing and/or computing means disclosed herein. Further, thedispensing and marking facility 104 may prepare the medication orderaccording to the validated medication and may associate certain relevantdata with the medication orders. The associated data could includepatient identification information, the facility in which the patientresides or receives care, locations within the facility (such as wing,floor, room, and the like), patient insurance information, facilitypersonnel associated with/responsible for the patient, administrationfrequency, and the like. The patient-related information (e.g. patientattributes/events 112) may be received either electronically viainterfaces with other systems (e.g. through the backbone 103) or viamanual inputs.

The dispensing and marking facility 104 may determine which medicationto dispense based on the prescription, the frequency of administration,and the like. In an example, based on inventory availability, thedispensing and marking facility 104 may apply business rules to select amedication that results in a different frequency of medicationadministration. The dispensing and marking facility 104 may also takeinto consideration patient care factors, such as sleeping hours,daylight, and the like to determine a time/date for each administrationof the medication. This may be called administration frequency type. Inan exemplary case, a frequency type is related to how many times per daya medication is to be administered; for example, twice a day or threetimes a day. Because “a day” may be defined as the waking hours of thepatient, a prescription that has a frequency type of 3 times per day mayresult in prescription administration times of 7 AM, 4 PM, and 11 PM.For a patient that prefers to sleep later than 7 AM, the administrationtimes may be set to 9 AM, 5 PM, and 12 AM. Of course otherfrequency-types and administration schedules are possible. Another typeof frequency may include set intervals, such as every 120 minutes, every4 hours, etc. Set interval frequency types may be adjusted based on thetime that the patient is awake, the time that a care provider wouldnormally be administering medication locally to the patient, and thelike. It may be important to note here the difference that exists in thetwo exemplary cases mentioned above, which is illustrated by the examplethat every 12 hours is not the same as twice per day where the day isdefined as the waking hours of the patient. Therefore, the methods andsystems described herein are able to take into account a particulartreatment's Times of Administration (“TOA”), which typically variesacross different treatments, patients, environments, and the like. Inembodiments, a TOA pattern is determined based on observation ofoutcomes using the outcome module 120, in particular to determine theinfluence of different TOA patterns on patient outcomes for a particularmedication given to patients of particular types over time.

Further, the dispensing and marking facility 104 may communicate themedication orders and the data associated with it to a medicationdispensing machine. A medication dispensing machine may dispense andpack the medications. In an example the communication may be in HL 7format. The medication dispensing machine may be similar to thedispensing, packaging, and bar coding systems currently commerciallyavailable, such as PEARSON MEDICAL'S iPACKT60 (TRADEMARK). Such machinesare able to receive instructions regarding the medication to bedispensed, grouping of the dispensed medications, and labeling ormarking of the packaging for the dispensed medications. Such machinesalso package the dispensed medications. Such packaging may includebar-coded pillow packs for the patient. Further the dispensing machinemay be located remotely. The remote dispensing of prescriptions may besupported by automated dispensing machines such as in-facility kiosks,third party home delivery chains, and the like. The remote dispensingmay include security to ensure proper authentication of the recipientthrough means like identifiers, passwords, finger scan, and the like.

Further, the medication dispensing machine may package the dosagesaccording to instructions from the dispensing and marking facility 104,and is able to package the dosages according to data associated with themedication order; for example, information related to the patient'sidentity, the time of administration, the facility in which the patientresides or receives care, locations within the facility (such as wing,floor, room, and the like), patient insurance information, facilitypersonnel associated/responsible for the patient, and administrationfrequency. The dosages may be packaged in packaging comprising human andbarcode information regarding the particular dosage of medications.Different dosage of medications for the same patients may be groupedtogether in the same package resulting from instructions to associate apatient's medication by patient identifying information, the facility inwhich the patient resides or receives care, locations within thefacility (such as wing, floor, room, and the like), patient insuranceinformation, facility personnel associated/responsible with the patient,administration frequency, and the like.

Further the medications packaged for a single dose may be labeled withthe barcode, which may be a conventional bar code or an advanced barcode, such as having graphical elements, human readable elements,holograms, 2D or 3D features, or the like. Identification informationmay also be embodied in a physical tag, such as an RFID tag, or a chip,such as used in a smart card, providing enhanced tracking functionalitywhen coupled with an appropriate reader or scanner. Such RFID, chip andsimilar hardware embodiments should be understood as encompassedthroughout this disclosure where barcodes and similar identifying marksare described herein. In an example, the single dose packages may bereferred to as pillow packs. The barcode or other identifier mayuniquely identify the patient, the prescription information, themedication to be administered, and general dosing rules and guidelines.The generation of this information may be automatic and may be assembledfrom information received at the prescription management facility 106,such as the information received from the prescribing facility 154.Further, the information may be prepared for use by the marking machinein the prescription management facility 106 and the information mayinclude data received from the E-EHR/E-EMR facility 118. Further in anexample, a pillow pack may be limited, such as to no more than, forexample, three different medications so a patient may have more than onepillow pack for an administration of medication. The pillow packs may beprepared and/or delivered individually for each administration, for alladministrations in one day, in a three or four day supply, in a 30, 60,90 day supply, and the like. In one preferred embodiment, eachadministration of medication, as planned by a prescribed TOA pattern, ispackaged into a single pillow pack or similar package, so that theprobability of the patient selecting the wrong medication, or the wrongamount of medication, is reduced.

Further, the dispensing and marking facility 104 may communicate with aplurality of dispensing locations and signal the locations to dispensespecific medications. The signaling to the locations may be based on avariety of factors including immediacy of the need for the medication,geographic proximity, availability and cost of transportation. Themedication dispensing and marking facility 104 may further recognize thecategory and composition (liquid, solid, etc.) of the to-be-dispensedmedication and route the dispensing to the appropriate dispensingmechanism. The labeling information may also be routed automatically tothe appropriate marking system. Further, the HPDMA 100 may have theability to keep track of the dispensed medications based on the proposedtime of administration, patient details and location of the patient(e.g. in patient resident, day patient, emergency room, clinic,third-party facility, residential home, personal address, and the like).The information may be used to assist in the accurate and efficientpackaging of the medications and treatments to be delivered to thecorrect location. Once delivered (as described below), the HPDMA 100 mayhave the ability to electronically read the information from thepackages of medications and treatments and confirm receipt by theappropriate personnel at the designated location.

After the prescribed medication has been properly packaged andinstructions have been marked on it, the dispensed medication may besent for delivery. The RX delivery facility 108 may be utilized fordelivering the dispensed medications. It should be noted that theportions of the computerized pharmacy services disclosed in co-pendingU.S. Nonprovisional patent application having Ser. No. 10/134,293 filedApr. 29, 2002 entitled CENTRALIZED PHARMACY BUSINESS METHOD (thedisclosure of which is incorporated in its entirety herein by reference)may be utilized in providing orders to customer facilities. The HPDMA100 may support loading the packaged prescriptions into medicationcarts. Carts may be associated with particular care facility locationproperties such as a particular facility, a floor in the facility, awing of the facility, etc. In this way, the packaged dosages having thereadable information thereon regarding the location of the patient, orthe cart in which the dosage should be stored, provide for easy andefficient loading of the cart. The RX delivery facility 108 may alsocommunicate in real-time with the backbone network 103 and maycommunicate the delivery details of the medication to other facilitiesof the HPDMA 100 via the backbone network 103.

Also, because the dosages are packaged according to the relevantassociated data (as described above) rather than simply in a 30-daysupply per drug per patient (as is the conventional case), the HPDMA 100may allow users to select the duration of supply. In an example, themedications packaged according to the above disclosure may be providedin shorter supplies than the typical 30-day-supply. While the durationof supply could be of any time duration, supplies for two to ten daysmay result in significant cost savings by eliminating the amount ofdrugs that need to be returned or destroyed due to stopped or changedorders.

Further, the prescription management facility 106 may be incommunication with an automated dispensing cabinet (ADC) on the premisesof a healthcare facility. The HPDMA 100 may perform the functionalitydescribed above and may instruct the ADC to dispense drugs oncereleased.

The prescription management facility 106 may perform similar functionsas those described above, with the alternative or additionalfunctionality of being able to provide healthcare facility professionalswith the information necessary to dispense medication from their ownmedication stores. Thus there may be a medication storage device orautomated dispensing cabinet (“ADC”) on a healthcare facility'spremises, and in addition to the facilities described above, amedication supply interface. The prescription management facility 106may be in electronic communication with the medication supply interface,and may provide notification which may be output through the medicationsupply interface that the medication is approved for administration andwhether the medication is in the medication storage device. Themedication management facility 106 may be kept constantly up to datewith regard to the inventory of the medication storage facility by theordering and administration functions described herein.

The elements within the area 106 shown in FIG. 1 may be collectivelyreferred to as a prescription management facility 106 and may includethe RX validation and selection facility 102, the dispensing and markingfacility 104 and the RX delivery facility 108. The prescriptionmanagement facility 106 may include other facilities as well and may notbe restricted to only these three facilities. The prescriptionmanagement facility 106 may include or use an information technologyinfrastructure, such as including one or more software applications,data storage facilities, and the like that may be accessible via anelectronic communication link, such as the Internet or other network,such as any type of network described herein.

Once the medication is delivered to the desired destination, it may beadministered. The administration of the medication may be conducted atthe prescription administration facility 110. The prescriptionadministration facility 110 may facilitate proper administration andreal-time data capture of prescription administration information. Theprescription administration facility 110 may utilize technology-enableddevices such as handheld barcode scanners, smart card chip readers, RFIDreaders, hologram readers, or other devices, in certain preferredembodiments used in proximity to the patient at the point and time ofadministration, thereby increasing the probability that data aboutadministration accurately reflects real events. Such devices mayautomatically read the coded information associated with the medication.Such devices may communicate with other portable computing devices suchas smart phones, PDAs, laptop computers, or other devices having afacility to enter data. The portable computing devices and/or thescanners are in communication with each facility described herein inconnection with FIG. 1. At the time of data collection, the use ofhandheld barcode scanners combined with contemporaneous entry of patientdata (often prompted by the system at the time of scanning as will bedescribed below) may allow real-time capturing of information about theevents associated with and immediately after administering medications.The handheld barcode scanner may also allow obtaining of the real-timedata and contextual information for the person performing theadministration. In an exemplary case, the person performing theadministration may be a patient, nurse, technician, physical therapist,or some other care provider. Further, the prescription administrationfacility 110 may access or communicate with a data center that mayprovide information from any of a variety of medical information relatedsources. Examples of data centers that provide relevant medicalinformation may include E-EHR/E-EMR 118, outcome databases 124, thirdparty databases 158, any of the facilities depicted in FIG. 1, and thelike. In an exemplary case, such access may typically be through awireless connection between a technology enabled device being used inassociation with administration 110 and a server or other networkeddevice. Further, the prescription administration facility 110 may becommunicatively coupled to the backbone network 103 and may communicatethe administration details in real-time to the other facilities via thebackbone network 103. The prescription administration facility 110 mayinclude an integration facility for automatically integrating data thatmay be captured in context of prescription administration and that maybe related to a medically-related event, healthcare related events,patient health condition data, patient physical activity data, patienttreatment data, patient oral consumption data, patient visitor data,patient outcome data patient psychological data, patient vital signs,patient dietary and nutritional data, and the like for establishing ormaintaining a patient's health record in association with theE-EHR/E-EMR facility 118. In an embodiment of the invention, the datacaptured in context of prescription administration may be referred to asmedication administration data. The prescription administration facility110 may also prompt a user of the technology enabled prescriptionadministration facility 110 device to enter (into the portable computingdevice or the scanner for example) information associated withadministration of the dosages of medication and also to verify that adosage has been administered to the patient.

In an embodiment of the invention, the medication administration datafrom the prescription administration facility 110 may be raw medicationadministration data. The raw medication administration data may not bein a format that may be integrated with the E-EHR/E-EMR facility 118.The prescription administration facility 110 may include a computer (notshown in the FIG. 1) that may transform the raw medicationadministration data to a format such that it may be integrated with thepatient's EHR in the E-EHR/E-EMR facility 118.

Further, the prescription administration facility 110 may facilitateproviding bedside prescription administration that may furtherfacilitate capturing all caregiver observations and clinical eventsperformed as part of the prescription administration. The dataassociated with the caregiver observations and clinical events performedmay be captured in real-time at the bedside as described above or may becaptured later from notes taken or entered into the system by thecaregiver. Further, because the information is collected at the bedsidethe prescription administration facility 110 may collect informationthat may not directly relate to the prescription administrationactivity. Such information may alternatively be obtained by the patientattribute and events facility 112. The information may be collectedusing sensors. In an example the sensor may be an accelerometer ormotion detector that detects patient movements, such as standing,walking, and the like. As will be described elsewhere herein, theinformation may further be utilized to populate an E-EHR/E-EMR facility118 in real-time.

Further, in an embodiment of the invention, the medicationadministration facility 110 may include a sensor that may detect openingof a pillow pack of the medication or a bottle of the medication or anyother container containing the medication. In an embodiment of theinvention, the sensor may be able to identify the geo-location of themedication package at the time the medication package is opened.Further, the detected location may be recorded in the E-EHR/E-EMRfacility 118. In an embodiment of the invention, the information aboutthe detected location may be transmitted by the sensor over a wirelessnetwork. In an example, the wireless network may be a WiFi network. Inanother embodiment of the invention, the information about the detectedlocation may be communicated through near field communication to ahandheld scanning device being used in the medication administrationevents. In yet another embodiment of the invention, the informationabout the detected location may be communicated through near fieldcommunication to a mobile device being used in the medicationadministration event. Further in embodiments of the invention, theinformation about the location of the medication package at the time themedication package is opened may also be recorded manually at the timeof administering that medication to the patient.

The bedside administration may further allow collecting data associatedwith elderly patients and patients in LTC. This data may include,without any limitations, psychiatric and psychologically relevantobservations, along with physical data. In an example, when an elderlypatient has undergone a heart surgery, the elderly patients tend to gointo depression or display symptoms of psychosis that may be caused byor exacerbated by an administered medication. As the HPDMA 100 allowsbedside data collection of prescription administration and treatment ofthe patient, the data related to the mental state of the elderly patientor the patient in the LTC may only be relevant if they are recorded byobserving the patient a significant amount of the time to allowobservation of changes. Further, this data may be recorded in theelectronic health record of the patient by the E-EHR/E-EMR facility 118.Further, this data may be used as early indications of a relatedcondition of depression or psychosis and may facilitate the prescriptionof additional medication or assigning of other therapies known toprevent deterioration in the nascent symptoms. In embodiments, thepsychological observations may be associated with TOA information, sothat patterns in psychological effects of medication administration canbe observed and tracked, such as using outcome module 120.

Further, at the time of administration, the administering professionalusing the HPDMA 100 may scan the medication barcodes, which may populatevarious fields in the administration facility 110 that may be displayedon a screen by or on the administration facility 110 for verificationand/or manual completion. Alternatively, or in conjunction with thescanning, data that may relate to the patient, care facility, caregiver, environment, observations, and the like as well as data relatingto the administration may be entered into the administration facility110, such as through a user interface. In an embodiment of theinvention, the handheld scanner scanning the medication barcodes orother health monitoring devices providing the patient's health conditiondata may generate a location data corresponding to the medication thatis being administered to the patient. In an embodiment of the invention,the location data may be generated by utilizing the Global PositioningSystem (GPS) facility embedded in the handheld scanner or othermonitoring devices. Once the information is entered, and prior toadministration, the information is communicated to the medicationmanagement facility 106. If current information in the medicationmanagement facility 106 shows that there has been a change to thepatient's medication, a stop order, or the like, may be communicated tothe administration facility 110 and displayed via the interface on thetechnology enabled administration device to the prescriptionadministrator. In this way, the HPDMA 100 may prevent the administrationof discontinued medications and ensure that the correct medication anddosage is being administered at the right time. The HPDMA 100 mightrequire the caregiver to uniquely identify themselves using a pluralityof identification methodologies. The collected identificationinformation may be validated, recorded, and stored to ensure compliancewith regulations and provide tracking information for the caregiver thatadministered the treatments or care.

Further, the prescription administration facility 110 may include atherapeutic equivalent facility which may accept electronic medicationorders and suggest therapeutic equivalents. Drug products classified astherapeutically equivalent may be substituted with the full expectationthat the substituted product may produce the same clinical effect andsafety profile as the prescribed product. Drug products may beconsidered to be therapeutically equivalent if they meet criteria suchas: they are pharmaceutical equivalents (contain the same activeingredient(s); dosage form and route of administration; and strength.);they are assigned by FDA the same therapeutic equivalence codes startingwith the letter “A” To receive a letter “A”, the FDA designates a brandname drug or a generic drug to be the Reference Listed Drug (RLD), andassigns therapeutic equivalence codes based on data that a drug sponsorsubmits in an Abbreviated New Drug Application to scientificallydemonstrate that its product is bioequivalent (i.e., performs in thesame manner as the Reference Listed Drug). The therapeutic equivalentfacility may contain a library of such therapeutic equivalents andsuggest them to the prescribing professional upon order entry based on,for example, whether the proscribed medication is on the patient'sinsurance formulary.

Further the HPDMA 100 may utilize the patient's information including,but not limited to, age, sex, medical condition, current diagnoses, andpast medication history to guide the caregiver in administeringmedication. Such information may, in various embodiments, be providedwith security to render it anonymous, such as for compliance withregulatory requirements relating to patient privacy.

The prescription administration facility 110 and the prescriptionmanagement facility 106 may allow capturing of the information about themedications that may be prescribed but not administered. Such cases mayoccur when a medication is prescribed but the prescription is notfilled, or when the prescription has been filled in the pharmacy, butthen the caregiver decides not to administer that medication or thepatient declines to take the medication. The reasons for notadministering the medication may include, without any limitations, thatpatient feels better and does not require the medication, that thepatient identifies that the side effect of the medication is too riskyand hence declines the medication, that the caregiver decides on adifferent medication, or the like. For example, if side effects of themedication include an upset stomach, and the patient already has anupset stomach, the caregiver may conclude it does not want to exacerbatethat side effect with medication.

Further, once the medication is dispensed and the doctor or thephysician determines that a different medication is required for thepatient, some of the original medication goes unused. In such a case,the status of the unused portion of the used medication gets updated inreal-time in E-EHR facility 118. The insurance and payments facility 138may obtain the information associated with unused medication from theE-EHR facility 118 to revise the billing accordingly. The pharmacyinventory status may also be updated with information regarding theunused medication and the unused medication may be returned back to thepharmacy or destroyed. The medications for a patient in LTC or otherin-patient care facility may be dispensed from the pharmacy for one doseat a time to avoid wasted medication or handling medications that may bereturned to the pharmacy. Thus, in certain preferred embodiments theHPDMA 100 may track non-administered medication, such as for outcometracking, payment/reimbursement, and other purposes.

The HPDMA 100 may further include the patient attributes and eventsfacility 112. The patient attributes and events facility 112 may monitorchange in patient's attributes in response to the prescribed medication.These changes may be communicated to other facilities via the backbonenetwork 103. The patient attributes and events facility 112 may furthertrack the events associated with the patient after consuming theprescribed medication. These events may be communicated in real-time tothe other facilities via the backbone network 103. Further, the changesin the events and attributes of the patient may correspond to treatmentoutcomes. Further the patient attributes and events facility 112 mayobtain the information collected at the bedside by the prescriptionadministration facility 110. This information may include, without anylimitation, on what side the patient is lying, how many times thepatient has turned his side, the position of the patient, changes in theposition of the patient, changes in the body position of the patient,changes in the movement of the patient, whether the patient is walkingor standing or sitting or sleeping, what the patient ate or consumed,whether the patient sleeping or awake, how much did the patient eat, howmuch did the patient drink, how much did the patient excrete and thelike. The information may further be associated with the caregiver andmay include, without any limitations, changing or dressing the bandagesof the patient, and the like. The monitoring of the patient's attributesand events may provide various types of data including, but not limitedto, patient health condition data, patient physical activity data,patient treatment data, patient outcome data, patient psychological dataand the like. Further, the various types of data may be recorded by theE-EHR/E-EMR facility 118.

In an embodiment of the invention, the various types of data from thepatient attributes and events facility 112 may be raw format and mayinclude raw patient health condition data, raw patient physical activitydata, raw patient treatment data, raw patient outcome data and rawpatient psychological data. The raw format of the various types of datamay not be in a format that may be integrated with the E-EHR/E-EMRfacility 118. The patient attributes and events facility 112 may includea computer (not shown in the FIG. 1) that may transform the raw formatof the various types of data to a format such that it may be integratedwith the patient's EHR in the E-EHR/E-EMR facility 118.

The outcome events facility 114 may then obtain the outcomes of thepatient's attributes and the events. The outcome events facility 114 maystore the obtained treatment outcomes and may also communicate them inreal-time to the other facilities of the HPDMA 100 via the backbonenetwork 103.

Further, the medical event streams on the backbone network 103, fromdifferent facilities of the HPDMA 100, may be utilized to populate theE-EHR/E-EMR facility 118. The medical event stream may include outcomesfrom prescription management events, healthcare planning events,laboratory events, medical payment events and treatment outcome events.

The E-EHR facility 118 may be associated with other facilities asdepicted in FIG. 1 and may exchange information (e.g. real-time data)with these facilities. The E-EHR facility 118 may maintain a collectionof health records of an individual and/or a group of individuals in aformat that may be capable of being shared across different medicalfacilities of the HPDMA 100 or with external facilities. In an exemplarycase, the health records may be shared electronically through theInternet and the like. Further, an E-EHR may include any related medicaldata and information, such as medical history, allergies, pathology andlaboratory test results, medical scanning reports, region andresidential information, psychological data, and the like.

Further, the E-EHR facility 118 may encompass information related to allthe facilities of the HPDMA 100 including administrative, nursing, lab,clinical, radiology, pharmacy, care planning, imaging, insuranceplanning, facility planning, rehabilitation, and the like. An electroniccommunication interface may be provided for implementing receiptinformation by the E-EHR facility 118 from the backbone network 103 andproviding the information from the E-EHR facility. Such an electronicinterface may thereby facilitate utilization of the E-EHR relatedinformation anywhere within the HPDMA 100. For example, lab reports of apatient stored in an E-EHR facility 118 may be utilized during careplanning to prepare a healthcare plan for a patient. Similarly, patientdata related to allergies and sensitivities may be utilized by a doctorto prescribe relevant medicines and offer treatment accordingly.Further, an E-EMR may be generated in association with the E-EHRfacility 118 and may be useful in an institution such as a hospital,clinic, physician's office, nursing home/center and the like.

Once the data from the medical event streams on the backbone network 103has been stored in the E-EHR/E-EMR facility 118, the medical data may beutilized by various other facilities of the HPDMA 100. The outcomefacility 120 may obtain the treatment outcome events from theE-EHR/E-EMR facility 118. The outcome facility 120 may utilize theelectronic interface of the E-EHR/E-EMR facility 118 to obtain thetreatment outcome data. Further, the outcome facility 120 may have abidirectional communication with the E-EHR/E-EMR facility 118.

The E-EHR/E-EMR facility 118 may also be coupled to the existing medicalrecord facility 122. The existing medical record facility 122 mayinclude hard copy and/or a database that may store the existing medicalrecords of a patient or a group of patients.

The outcome database facility 124 may be communicatively coupled to theoutcome facility 120 to obtain the treatments and outcomes for themedication being administered to the patients. The outcome databasefacility 124 may include a plurality of databases that may store thetreatments and outcomes data for a plurality of similar patients. Theoutcome database facility 124 may also be communicatively coupled to thebackbone network 103 and may obtain treatments and outcomes data inreal-time. Further, the outcome database facility 124 may communicatethe treatment outcomes of the patient to other facilities of the HPDMA100 through the backbone network 103.

Further, the outcome database facility 124 may be coupled to the outcomeanalytics facility 128 that may utilize the treatment outcomes of thepatient to generate medical reports, medical predictions and othermedical analyses. The outcome analytics facility 128 may utilize thedemographic information associated with the patient, informationregarding the administration of the medication and clinical outcomes,and the like to generate the reports, predictions and other analyses.The administration information may include the time of administrationand the dose of medication. The output of the outcome analytics facilitymay be utilized by other facilities of the HPDMA 100. Further theoutcome analytics facility may access the third party data 158 toproduce the reports and predictions. Third-party data may includemedical studies, trials, FDA related data, orange book data, and thelike.

Further, the outcome data may be utilized to determine the condition ofthe patient's health, adverse event for a particular drug, sampling ofpatients with an infectious disease, monitoring of patient flow duringan epidemic, outcome of a clinical test, and correlation of disease incase the clinical test is found to be positive or some other kind ofoutcome related to healthcare data. In this aspect, the outcomeanalytics facility 128 may include an analytic workbench facility thatmay provide different modules for conducting statistical analysis of theoutcome data. Such an analytic workbench facility may implement one ormore statistical techniques including, but not limited to, Analysis ofVariance (ANOVA), Chi-square test, Correlation, Factor analysis,Mann-Whitney U, Mean square weighted deviation (MSWD), Pearsonproduct-moment correlation coefficient, Regression analysis, Spearman'srank correlation coefficient, Student's t-test, Time series analysis,Bootstrap & Jackknife Resampling, Statistical classification,Statistical surveys, Structured data analysis (statistics), Survivalanalysis, Multivariate discriminant analysis, Linear discriminantanalysis, Cluster analysis, Principal component analysis, and the like.

By leveraging the real-time bed-side data collection capabilities of theHPDMA 100 along with support for accessing a plurality of enhancedelectronic health records, the outcome facilities (e.g. outcome facility120, outcome database facility 124 and, outcome analytics facility 128)may facilitate rapidly detecting an onset of an epidemic type situation.By combining outcome analysis 128 with real-time data it may be possibleto identify patients infected with an infectious disease at the firstscreening. For example, the various symptoms of an epidemic-type diseasemay be stored in the outcomes database and a patient's real-timesymptoms may be captured and entered into the outcome analytics facility128 (e.g. analytics workbench) to facilitate identifying a patient withsuch a disease. Likewise, the analysis capabilities of the analyticworkbench may support regression analysis to facilitate determininggenetic modification of a virus over a period.

Similarly, real-time event data may be associated with the outcome. Theanalytic workbench facility may perform statistical analysis todetermine whether the occurrence of a specific event is significant tothe outcome data. A feedback may be provided to the associated medicalspecialist, in case the event is statistical and significant to aspecific patient. The analytic workbench facility may be programmed todynamically select the best algorithm in a specific situation.Alternatively, the analytic workbench facility may include a GUIenabling the user to select the algorithm to be applied.

In association with the outcome analytics facility 128, various machinelearning techniques may be implemented using neural networks to improveon the analytics as well as to facilitate predicting outcomes. Varioustypes of neural networks may be employed including learning algorithms,reinforcement-learning algorithms, supervised learning algorithms, andunsupervised learning algorithms. Further, other techniques includegenetic algorithms, biological cybernetics, biologically inspiredcomputing, cerebella model articulation controllers, cognitivearchitecture, cultured neuronal networks, neural network software,neuro-fuzzy approaches, neuroscience, predictive analytics, radial basisfunction networks, recurrent neural networks, self-organizing maps,simulated reality, hidden markov models, kalman filters, decisiontheory, support vector machines, tensor product networks, time adaptiveself-organizing maps, time delay neural networks and the like.

Additionally, the analytic workbench facility may utilize learning totrain suitable techniques for optimum prediction. The prediction of afuture outcome based in part on an earlier outcome may be an integralpart of the analytic workbench facility. In this regard, the analyticworkbench facility may extrapolate data to identify future eventsassociated with the patient and raise an alert to doctors about thesefuture events. For example, outcomes for a plurality of patientsexperiencing a range of symptoms who have been administered a drug maybe used to predict an outcome of a patient with similar symptoms who maybe prescribed a similar drug. This predicted outcome may include certainside effects that can be prevented with proper preventive treatment.Even if these side effects were not present in the FDA trials before thedrug was allowed on the market, the analysis of outcomes combined withother information collected by the HPDMA 100 may facilitate predictingthese outcomes in patients.

The machine learning techniques may utilize algorithms that may performvarious data mining operations on the data such as classification,clustering and other data mining techniques known in the art. To thisend, the effect of various drugs on a particular disease may be studied,and an identification relating to the effect of the drug may berecorded. For example, brand X may cause fewer side effects, whenadministered to children, than brand Y. Likewise, in another example,brand Y may be more effective in critical conditions. These analyses mayhelp doctors and other medical staff to create a knowledge map fortreatment under different conditions.

Machine learning may be performed by taking into account a weight thatreinforces a particular outcome. An initial set of weights may bedetermined based on, for example, a prediction, theory, hypothesis, orthe like as to the importance of a particular factor or factors, thenadjusted by feeding actual outcomes into the machine learning system.For example, the machine learning may initially append a weight X if thedrug is believed to be suitable, then adjust the weight based on actualoutcomes as tracked in the outcome module 120. Likewise, if theadministered drug cures the patient slowly and subsequently allows thepatient to recover completely, a higher weight (XX) may be assigned bythe machine learning algorithm. Similarly, if an administered drugresults in quick recovery then a much higher weight (XXX) may beassigned to the medication and/or treatment by the machine learningalgorithm. In an emergency situation, the doctors may use outcomeprediction based on machine-learning techniques employed in the outcomeanalytics facility 128 to confirm an initial diagnosis that may havebeen made by a field emergency medical technician. In certain preferredembodiments weights will be multivariate, such as taking into accountthe medication, the TOA pattern for the medication, clinical treatmentfactors, psychological observations, and the like. Similarly, theoutcomes that are fed into the machine learning system may vary, such asincluding extent and timing of recovery, mitigation or exacerbation ofside effects, financial factors, observation of satisfaction orpsychological factors, and the like.

Further, clinical outcomes of the medication may be measured usingindicators like, but not limited to, disease control, risk reduction,and health care analysis of the patient undergoing treatment. Clinicaloutcomes of a medication may also be measured using monetary terms byanalyzing the economical perspective of the medication. The method formeasuring clinical outcomes in monetary terms may include: a)determining the most appropriate clinical outcome of the medication; b)establishing monetary investment on achieving the most appropriateclinical outcome, and thereafter, calculating a financial value for themost appropriate clinical outcome as per the monetary investment for themedication.

The above calculated financial value may be an indicator of thecost-benefit analysis of the medication. The financial value may becalculated for a drug, treatments, a medical facility, a health-caremanagement solution, a disease reduction program, and the like.

The financial value may be employed as an indicator for ranking amedication, a drug, treatments, a medical facility, a health-caremanagement solution, a disease reduction program, and the like. Forexample, there may be more than one effective medication that may beused to treat a set of diagnosed symptoms; one of these may be moreexpensive than the other but equally beneficial with regard toalleviating symptoms of the patient. In this scenario, the financialvalue may determine the selection of the medicine in order to providethe best clinical outcome for the dollars spent.

Other factors may be combined with the cost of medication to arrive atthe most effective financial outcome in offering treatment. Forinstance, factors such as a pharmacy management information system, theprescription management facility 106, the insurance and paymentsfacility 138, and the like, may be combined to arrive at numerousalternative pharmacy management features. The insurance company mayselect a specific pharmacy management feature to reimburse the hospitalor patient in the management of a particular disease. Validation of anRX may include the rating of the medication prescribed and that ratingmay influence the rate of reimbursement that may be dispensed by theinsurance company. For instance, one pharmacy management feature mayinclude an RX with various factors such as expensive medications andadditional therapies such as alternative medicine and psychotherapy thatmay be incidental to the patient's recovery; another pharmacy managementfeature may include other factors that include less expensive butefficacious medications and only those therapies such as physiotherapy,drug therapy and occupational therapy that may be most essential to thepatient's recovery. In such a scenario, the insurance company may havethe option of preferring to pay for the RX that it considers mostsuitable for treating the patient and, based on validation of the RX, itmay prefer to reimburse cost of the latter line of treatment and rejectthe former.

Further, the output of the outcome analytics facility 128 may beutilized by the rehabilitation and LTC facility 130 to plan a long termcare or the rehabilitation treatment for the patient. This planning maybe based on the different parameters such as background needs of thepatient, medical equipment needs, home healthcare environment needs,nutrition, supply, commodities, education & training, and the like.These parameters may be obtained from the reports and the predictionsmade by the outcome analytics facility 128. Further the rehabilitationand LTC facility 130 may obtain real-time medical event streams from thebackbone network 103. The rehabilitation and LTC facility 130 may alsocommunicate its events to other facilities via the backbone network 103.Further, the E-EHR/E-EMR facility 118 may store the event outcomes fromthe rehabilitation and LTC facility 130, thus creating the enhanced orenriched version of an E-EHR.

Another embodiment of the invention may provide real-time data regardingaspects of a long term health care facilities' prescription andadministration of drugs. The HPDMA 100 may include a real-time reportingfacility which is configured to store data related to any one of theidentities of the patients, the identities of the personnel who care foror are responsible for the patient, medications prescribed, medicationsthat were returned or destroyed, costs associated with medications thatwere not covered or only partially covered by a payer, costs associatedwith medications for which the health care facility had to pay, and thelike. The real-time reporting facility may associate any of the aboveparameters with any other of the above parameters. The real-timereporting facility may also provide up-to-the-minute and time-basedsummary information regarding the above parameters and any of therelated parameters. Such information may be presented to a user via theworkstation, for example, with text, graphics, charts, and the like.

The output of the outcome analytics facility 128 may be utilized by thethird party integration facility 132. A third party integration facility132 may facilitate the use of third party tools, such as paymentmanagement tools, data quality tools, research tools, languagetranslation tools, data normalization tools, and the like in associationwith the HDPMA 100 facilities, methods, and systems depicted in andescribed in relation to FIG. 1 and other figures herein.

The labs and imaging facility 134 may also utilize the predictions andreports associated with the patients from the outcome analytics facility128 to conduct diagnostic tests on the patients. The labs and imagingfacility 134 may further communicate the laboratory outcomes for thepatient to other facilities of the HPDMA 100 and these outcomes mayfurther populate the E-EHR/E-EMR facility 118.

The reports and predictions from the outcome analytics facility 128 mayfurther be utilized by the insurance and payments facility 138 toprepare billing reports for the patient. The reports and predictionsfrom the outcome analytics facility 128 may include details about themedications administrated to the patient. These details may be utilizedby the insurance and payments facility 138 to identify the reimbursementand the non reimbursement medications. The insurance and paymentsfacility 138 facility may further communicate these billing details overthe backbone network and these details may be utilized by the otherfacilities of the HPDMA 100.

The output of the outcome analytics facility 128 may further be utilizedby the regulatory facility 140. The regulatory facility 140 may beinvolved in planning and decision making for improving and meetingcompliance, addressing existing deficiencies in the processes, reducingbusiness risks, and the like.

The output of the outcome analytics facility 128 may further be utilizedby the pharmacy planning facility 142. In an exemplary case, the outputof the outcome analytics facility 128 may reveal that many people sufferfrom a side effect, e.g., stomach infection, after taking a particularmedication (and in embodiments, such information is collected byprescription administration facility as described herein). In light ofthis observation, the pharmacy planning facility 142 may change theprescription instructions. In extension to this, the pharmacy planningfacility 142 may also include devising methods and processes to makethis information public by means of improving product packaging throughprint and electronic media, and the like. The pharmacy planning facility142 may further include development of a medication that is easier todigest or development of a medication that may suppress the side effectsof the previous drug.

The output of the outcome analytics facility 128 may further be utilizedby the facility planning facility 144. In an exemplary case, the outputmay include the ratio of inpatient and outpatient services, older andcritically sick patient population, treatment patterns, advancement intechnology, health data related to diseases and conditions (asthma,cholesterol, diabetes, heart disease, hypertension, obesity, etc.), typeof healthcare (ambulatory services, ER visits, etc.), data related toinjuries (accidents, suicides, homicides, etc.), life stages andpopulation (births, deaths, women's health, children's health, state andterritorial distribution, etc.), lifestyle (drug use, smoking, exercise,etc.), and the like. Further, a long term care center or a facility mayprovide rehabilitative, restorative, and/or ongoing skilled nursing careto patients or residents in need of assistance with activities of dailyliving. This facility planning may require specific consideration anddesign than the facility planning for a general healthcare center sinceit may cater to the needs of a specific group (e.g., elderly orhomeless) that are otherwise not able to get focused healthcare andattention. Examples of long-term care facilities may include nursinghomes, rehabilitation facilities, inpatient behavioral healthfacilities, long-term chronic care hospitals, and the like. Long termcare facilities may be designed to make them safe, functional, durableand relatively easy to maintain. Some parameters to be considered whiledesigning long term care facilities may include design, layout,ambience, color management, dining and food management, online andkiosk-based layouts, ease of access for the handicapped and the like.For example, the facilities may be designed to include automatic IDscanners for residents using the dining facility; it may also bedesigned to facilitate easy movement for a patient confined to awheelchair.

The output of the outcome analytics facility 128 may further be utilizedby the insurance planning facility 148. The planning by the insuranceplanning facility 148 may be done regarding coinsurance options, i.e.,the amount that is required to be paid for medical care in afee-for-service plan after meeting the deductibles. Further, theplanning may also be performed regarding the suitability and selectionof insurance plans based on the requirements of an individual. Examplesof various plans may include basic plans, Health maintenance (HMOs),Preferred Provider Organizations (PPOs), Points of Service (POS), andthe like. Other aspects that may be significant for insurance planningmay include information on customary fee, exclusions, maximumout-of-pocket expenses, non-cancellation cases, premium, and the like.

The output of the outcome analytics facility 128 may further be utilizedby the dashboard facility 150 to generate different kinds of reports andto allow medical-related personnel to interact with the facilitiesand/or data available through the HPDMA 100. In an exemplary case, thedashboard facility may provide a specialist dashboard, a clinicaloutcome dashboard, a Long Term Health Care (LTC) administratordashboard, a LTC facility specific dashboard, a pharmacist dashboard,various planning dashboards, prescription management dashboards, and thelike. Each dashboard may have different looks that may be represented bydata entry or display fields or tabs. The dashboards may be populated inreal-time with the data from any of the facilities depicted in FIG. 1including the E-HER facility 118. Further, the dashboard facility 150may be communicatively coupled to the backbone network 103 to allowreal-time updating of an onscreen display of a dashboard withinformation collected in real-time (e.g. medication administration orpatient event data).

The output of the outcome analytics facility 128 may further be utilizedby the care planning facility 152. Care planning may include theplanning of any aspect of patient care and may be based at least in parton data provided by an E-EHR/E-EMR 118, actual outcomes 124, predictedoutcomes, and other analytics provided by the outcomes analyticsfacility 128. A physical rehabilitation facility manager may adjust aschedule of care takers and rehabilitation specialists based on theoutcomes or predicted outcomes for patients being treated in regionalhospitals. A nurse may be notified that a patient on her shift hasrecently started a medication that, based on an outcome prediction, willmake the person thirsty, so that the nurse can ensure that the patienthas plenty of fluids available. These are only examples of a fewpotential care planning facility 152 features and therefore are notrepresentative of all of the features of the care planning facility 152.

FIG. 2 is a detailed schematic depiction of an exemplary embodiment ofmedication management facility 106. The medication management facility106 may include a medication validation and billing facility 102 and anelectronic order entry facility 204 accessible by a validationworkstation 210 and coupled to a medication dispensing machine 104 thatmay generate patient and dose specific packaged medication 222. Themedication management facility 106 may also include a medication or RXdelivery facility 108 that may include a medication cart 216 on whichthe dispense medication 222 may be arranged so that it can be read by anid reader 220 that may communicate directly or through a workstation 218with the medication validation and billing facility 102, such as throughthe Internet.

As with all facilities described herein, some of the facilities depictedin FIG. 2 may be embodied as physical devices (e.g. computers, machines,carts, packaged medicine, scanners, and the like), and some may beembodied as either software or a combination of software and hardware.In an example, electronic order facility 204, medication validation andbilling facility 102 may be embodied as one or more softwareapplications executing on a processor, such as a web server that is incommunication with the other devices as depicted in FIG. 2.

The electronic order entry facility 204 may include a user interface foraiding a health specialist to enter electronic medication orders andother prescription-type orders. The user interface may be displayed onthe validation workstation 210, a prescribing facility 154 (as shown inFIG. 1), any other electronic communication device (e.g. a mobile phone,a hand-held prescription entry device, and the like). The medicationvalidation facility 102 may use security-type identification methods touniquely identify, record, and document the person entering the orders.As described herein, the medication validation and billing facility 102may be configured to facilitate verifying formulary compliance of theordered medication(s), determining drug allergy information associatedwith the prescribed drugs, confirming the drug interaction informationassociated with the entered electronic medication orders, and otherprescription validation, inventory compliance checks, billing compliancechecks, and the like. On the basis of any of these or other validationchecks performed by the facility 102, a signal may be sent to the source(e.g. a workstation, etc) of the electronic medication order to warn theprescriber on a patient-by-patient basis. Such warnings may need to beresolved before accepting the order.

To facilitate compliance with pharmacy regulations and generally supporta high degree of quality control, a user interface accessible on thevalidation workstation 210 may include a utility that may allow apharmacist to approve the electronic medication orders after havingreviewed all the relevant information. The approval of the electronicmedication orders may also herein be referred to as releasing theorders. Further, the medication validation and billing facility 102 mayassociate relevant data to the released orders, such as patientidentifying information, the facility in which the patient resides orreceives care, locations within the facility (such as wing, floor, room,etc.), patient insurance information, facility personnelassociated/responsible for the patient, administration frequency, andthe like. The information regarding the patient may be received eitherelectronically via interfaces to other systems (e.g. as depicted inFIG. 1) or via manual input (e.g. through a user interface of thevalidation workstation 210).

After the medication order has been approved, the medication validationand billing facility 102 may communicate the released orders and thedata associated therewith to a medication dispensing machine 104. In anexample, the communication between the medication validation and billingfacility 102, and the medication dispensing machine 104 may be in HL7format. The medication dispensing machine 104 may also receiveinstructions regarding the medications to be dispensed, how to group thedispensed medications, and how to label the packaging of the dispensedmedications 222. On the basis of the received instructions, themedication dispensing machine 104 may package the medications intoindividually packaged dosages. The medication dispensing machine 104 mayalso package the dosages according to data associated with the order,for example, information related to the patient's identity, the time ofadministration, the facility in which the patient resides or receivescare, locations within the facility (such as wing, floor, room, etc.),patient insurance information, facility personnel associated/responsiblefor the patient, administration frequency, medication cart number, andthe like. The dosages may be packaged in packaging comprising human andelectronically readable information regarding the particular dosage ofmedications. Electronically readable information could, in embodiments,be bar-coded, although any other traceable marking or device may beemployed (RFID, 2D code, matrix code, and the like). In an example, themedication dispensing machine 104 may package bar-coded pillow packs forthe patient. Further, different dosages of medications for the samepatients could be grouped together in the same package resulting frominstructions to associate a patient's medication by patient identifyinginformation, the facility in which the patient resides or receives care,locations within the facility (such as wing, floor, room, etc.), patientinsurance information, facility personnel associated/responsible withthe patient, administration frequency, and the like.

Further in an embodiment of the invention, the dispensed medications 222may be packaged and transported to a health care facility that may belocal to the dispensing machine 104 or may be remotely located. Thedispensed medications 222 may be transported (e.g. on a medication cart216 into which the packaged medication dosages may be loaded) from thedispensing machine 104 to a health care facility. In an example, thehealth care facility may receive a plurality of medication carts 216,each of which may be associated with a particular location in thefacility such as a particular facility, a floor in the facility, a wingof the facility, etc. In this way, the packaged dosages having readableinformation thereon that describe the intended location of the patientor the cart in which the dosage should be stored, may provide for easyand efficient loading of a medication cart 216. The dispensed medicine222 may be automatically loaded onto one of the medication cards 216that may be located near the dispensing machine 104. Alternatively, thedispensed medication 222 may be transported in bulk to a distributionlocation (e.g. a nurse's station or an in-house pharmacy) and loadedonto a medication card 216 manually.

To facilitate management of medications stored on a medication cart 216,a reader 220 and a medication workstation 218 may be used in theprocessing of medicine cart-based dispensed medications 222. One or moreuser interfaces displayed on the medication workstation 218 may supportvarious work flow processes associated with medication dispensing,transport, delivery, and the like. The reader 220 and medicationworkstation 218 may be used at any of a variety of events (e.g. asdefined by the work flows) associated with the sorting, distribution,transport, delivery, unpacking, administration, and disposal ofdispensed medications 222. In an example of remote sorting andmedication cart 216 loading, a person may use a code reader to capture amarked code on a pillow pack of medication and select a medication cartloading work flow. The captured data may be transmitted (e.g. over theinternet) to the medication validation and billing facility 102 where itmay be used to lookup medication cart 216 loading instructions that maythen be sent back to the medication workstation 218 to be used by theperson loading the medication cart 216. In an example of dispensedmedication 222 being transported in the medication cart 216, a personmay scan a label on the medication cart 222 and select a transportationwork flow. The scanned data may be communicated to the validation andbilling facility 102 which may respond with specific facility floor andwing information that may be displayed on the medication workstation218. The person may use the displayed location information to forwardthe medication cart 216. Upon arrival of the medication card 216 at thedesignated floor/wing, a person (e.g. a nurse) may scan the label on thecart 216 again to signify that the cart 216 has been received. Furtherin the example, to begin delivering the individual medication dosages topatients on the wing, a nurse may scan the cart 216 label and select afinal delivery workflow on the medication workstation 218. Although theexemplary embodiments described above include specific communicationswith the medication validation and billing facility 102, some or all ofthese communications may be changed to support batch informationtransfer. For example, when the medication cart 216 is loaded near themedication dispensing machine 104, a batch of data representing theloaded cart 216 may be sent to medication workstation 218 to facilitateautonomous handling of the loaded cart 216 at the selected destination(e.g. long term care facility). Other combinations of real-time andbatched communications are possible and are included herein.

FIG. 3 depicts a detailed diagrammatic view of an exemplary embodimentof the outcome analytics facility 128, in accordance with an embodimentof the invention. The outcome analytics facility 128 may be utilized todetermine the condition of the patient's health, adverse event for aparticular drug, sampling of patients with an infectious disease,monitoring of patient flow during an epidemic, outcome of a clinicaltest, correlation of disease in case the clinical test is found to bepositive or some other kind of outcome related to healthcare data, andmany other types of outcome analytics. Results of the outcome analyticsfacility 128 may be used by other facilities as depicted in FIG. 1 andits accompanying descriptions.

The outcome analytics facility 128 may include an input facility 302, ananalytic workbench facility 304, a machine learning facility 308, and anoutcome weighting facility 310, and an analytics technique facility 312.The input facility 302 may facilitate receiving a variety of differenttypes of outcome data to be analyzed, such as data from the outcomedatabases 124, the third party databases 158, and the like. Data thatmay be processed by the outcome analytics facility 128 may includeprescription data, medication administration data, E-EHR/E-EMR data,data associated with patient's attributes, third party data, treatmentoutcomes and the like. The input facility 302 may provide some initialdata processing to normalize data and/or otherwise transform it to besuitable for further analysis by the analytic workbench facility 304,the machine learning facility 308, and/or the outcome weighting facility310. Further, the input facility 302 may provide data provided to theanalytics facility 128 to analytics processing facilities that mayinclude the analytic workbench facility 304 or the machine learningfacility 308. For example, the input facility 302 may provide a trainingdata set to the machine learning facility 308 for training the machinelearning facility 308. In another example, the input facility 302 mayoptionally direct received outcome data to an outcome weighting facility310.

In an embodiment of the invention, the analytic workbench facility 304may predict an outcome of a medically-related event by implementing oneor more statistical techniques obtained from the analytic techniquefacility 312. The analytic technique facility 312 may include, withoutany limitation, regression analysis, iterative analysis, complexmodeling, multivariable analytics, Analysis of Variance (ANOVA),Chi-square test, Correlation, Factor analysis, Mann-Whitney U, Meansquare weighted deviation (MSWD), Pearson product-moment correlationcoefficient, Regression analysis, Spearman's rank correlationcoefficient, Student's t-test, Time series analysis, Bootstrap &Jackknife Resampling, Statistical classification, Statistical surveys,Structured data analysis (statistics), Survival analysis, Multivariatediscriminant analysis, Linear discriminant analysis, Cluster analysis,Principal component analysis, and the like. Depending on the type ofprediction or analysis function that is to be performed by the analyticsfacility 128, one or more of these techniques may be selected for use bythe analytics engine. The analytic techniques facility 312 may be adatabase of algorithms that may be accessible to the analytics enginefacility 304.

Similarly, real time event data may be associated with the outcome. Theanalytic workbench facility 304 may perform statistical analysis todetermine whether the occurrence of a specific event is significant tothe outcome data. Feedback may be provided from the analytics facility128 to a caregiver in case the event is statistical and significant to aspecific patient. In another embodiment, the analytic workbench facility304 may include a feedback loop that may be utilized for correcting theoutput and/or the outcome. For example, the data provided to theanalytics engine facility 304 may have missing data; the missing datamay be fitted accordingly to the standard techniques known in the art.In addition, the output may be fed back into the analytics enginefacility 304 for correcting the deviation of output to the actualoutput; for example, degeneration of virus may follow a Poisson'sdistribution rather than exponential distribution.

Further, the analytic workbench facility 304 may be programmed todynamically select the best algorithm in a specific situation.Alternatively, the analytic workbench facility 304 may include a GUIenabling the user to select the algorithm to be applied. Additionally,the analytic workbench facility 304 may utilize the previous learning totrain in suitable techniques for optimum prediction. In an embodiment,the prediction of the future event based on the earlier event may be anintegral part of the analytic workbench facility 304. In this regard,the analytic workbench facility 304 may extrapolate data to identifyfuture events associated with the patient and raise an alert to doctorsabout these future events. For example, administration of aspirin mayreduce the phenomena of clotting in a patient; however, because of anemergency, the drug (aspirin) may be administered to the patient. Inthis scenario, the analytic workbench facility 304 may alert the medicalstaff about the possible reduction in clotting of blood. The doctoroperating upon this patient may be informed in advance in order to takeremedial action.

In another embodiment of the invention, a machine learning facility 308may be implemented using neural networks to produce the predictedoutcomes. Various types of neural networks may be employed includinglearning algorithms, reinforcement-learning algorithms, supervisedlearning algorithms, and unsupervised learning algorithms. Further,other techniques include genetic algorithm, biological cybernetics,biologically inspired computing, cerebella model articulationcontroller, cognitive architecture, cultured neuronal networks, neuralnetwork software, neuro-fuzzy, neuroscience, predictive analytics,radial basis function network, recurrent neural networks,self-organizing map, simulated reality, hidden markov model, kalmanfilter, decision theory, support vector machine, tensor product network,time adaptive self-organizing map, time delay neural network and thelike.

Further, the machine learning facility 308 may be used to performvarious data mining operations on the data such as classification,clustering and other data mining techniques known in the art. To thisend, the effect of various drugs on a particular disease may be studied,and an identification relating to the effect of the drug may berecorded. For example, brand X may cause fewer side effects, whenadministered to children, than brand Y. Likewise, in another example,brand Y may be more effective in critical conditions. These analyses mayhelp doctors and other medical staff to create a knowledge map fortreatment under different conditions.

In an embodiment, machine learning may be performed by taking intoaccount a weight from an outcome weighting facility 310 that reinforcesa particular result. For example, the machine learning facility 308 mayapply a weight X in an outcome prediction if a drug associated with theprediction is found to be suitable. Likewise, if the administered drugcures the patient slowly and subsequently allows the patient to recovercompletely, a higher weight (XX) may be assigned to the outcome in themachine learning algorithm. Similarly, if an administered drug resultsin quick recovery then a much higher weight (XXX) may be assigned to theoutcome in the machine learning algorithm. In an embodiment, both theanalytics engine facility 304 and the machine learning facility 308 maybe simultaneously utilized for predicting the outcome of the input data.For example, the input data may be first passed to the analytics enginefacility 304 and subsequently to the machine learning facility 308 fordetermining the predicted data. In another example, the input data maybe first passed to the machine learning facility 308 and subsequently tothe analytics engine facility 304 for determining the predicted data.

In another embodiment, a feedback loop may be provided in associationwith the machine learning facility 308 to reintroduce a part of thepredicted outcome data back into the machine learning facility 308. Inthis scenario, the feedback loop may either be a positive feedback or anegative feedback, reinforcing the outcome in the first case and dampingthe outcome in the latter case. In another embodiment, the machinelearning may be in the form of weighted feedback and the weightsintroduced in the feedback loop may determine the outcome of thepredicted data.

FIG. 4 illustrates a process and system 400 for automaticallyestablishing an Enhanced Electronic Health Report (E-EHR) withmedication administration data of a medically-related event that isautomatically collected in real-time in proximity to a patient, inaccordance with an embodiment of the invention. The process begins atstep 402. At step 404, medication administration data 408 of themedically-related event associated with the patient may be collected.The step 404 of collecting the medication administration data 408 of themedically-related event may be accomplished by an automatic datacollection facility in proximity to the patient such as those describedherein. In embodiments, the automatic data collection facility may be amachine reader. In an embodiment of the invention, the machine readermay be a handheld barcode reader facility 410. The handheld barcodereader facility 410 may read the barcodes on the packaging of a dosageof medication and may be in electronic communication with theprescription administration facility (not shown in the FIG. 4). Themedication administration data 408 may be raw medication identificationdata that may be transformed to be suitable or used with a medicationinformation database, or it may include the medication, time ofadministration, dosage, reaction data, and administration of a dosage ofmedication.

As described herein, additional data about the medically-related event(which in embodiments may be the medication administration data 408) maybe fed into a computer 412. As an example, a caregiver might scan thecoded information on a medication packet to initiate the process 400.The coded information may be automatically read by the automatic datacollection facility. The medication administration facility (110 inFIG. 1) may also prompt the user to enter other relevant data about thepatient's current condition at the time of medication administration,which in embodiments such input may be into the automatic datacollection facility or into one of the various smartphones, computingdevices, etc. in electronic communication with the automatic datacollection facility and/or other facilities disclosed in connection withFIG. 1.

After the medication administration data 408 of the medically-relatedevent associated with the patient has been collected at step 404, thehandheld barcode reader facility 410 may communicate via an electroniccommunication, the collected medication administration data 408, to thecomputer 412, which may represent any of the facilities depicted in FIG.1 (e.g. prescription management facility 106, prescribing facility 154,outcome database module 124, and the like). In an embodiment of theinvention, the electronic communication may be the Internet. Thereafter,at step 414 the medication administration data 408 and other informationmay be integrated automatically in real-time with the patient's EHR 418to establish the E-EHR 420 of the patient. The step 414 of integratingthe medication administration data 408 and other information may beaccomplished by using the computer 412. The step 414 may further includeusing the computer 412 to transform the raw medication administrationdata so that it can be integrated with the patient's EHR. The processends at step 422.

FIG. 5 illustrates a process and system 500 for automaticallymaintaining an E-EHR with prescription administration data of ahealthcare-related event that is automatically collected in real-time inproximity to a patient, in accordance with an embodiment of theinvention. The process begins at step 502. At step 504, the prescriptionadministration data 508 of a healthcare-related event associated with apatient may be collected. The step 504 of collecting the prescriptionadministration data 508 of the medically-related event may beaccomplished by an automatic data collection facility in proximity tothe patient such as those described herein. In embodiments, theautomatic data collection facility may be a machine reader. In anembodiment of the invention, the machine reader may be a handheldbarcode reader facility 510. The barcode reader facility 510 may readthe barcodes on the packaging of the dosage of medication and may be inelectronic communication with the prescription administration facility(not shown in the FIG. 6). Further, the prescription administration data508 may be raw prescription administration data that may be transformedto be suitable or used with a medication information database.

As described herein, additional data about the medically-related event(which in embodiments may be the prescription administration data 508)may be fed into a computer 512. As an example, a caregiver might scanthe coded information on a medication packet to initiate the process500. The coded information may be automatically read by the automaticdata collection facility. The medication administration facility (110 inFIG. 1) may also prompt the user to enter other relevant data about thepatient's current condition at the time of medication administration.

After the prescription administration data 508 of the medically-relatedevent associated with the patient has been collected at step 504, thehandheld barcode reader facility 510 may communicate via an electroniccommunication, the collected prescription administration data 508, tothe computer 512 which may represent any of the facilities depicted inFIG. 1 (e.g. prescription management facility 106, prescribing facility154, outcome database module 124, and the like). In an embodiment of theinvention, the electronic communication may be the Internet. Thereafter,at step 514 the prescription administration data 508 and otherinformation may be integrated automatically in real-time with thepatient's E-EHR facility 518 to maintain the E-EHR facility 518. Thestep 514 of integrating the prescription administration data 508 andother information may be accomplished by using the computer 512. Thestep 514 may further include using the computer 512 to transform the rawprescription administration data 508 so that it can be integrated withthe patient's EHR. The process ends at step 520.

FIG. 6 illustrates a process and system 600 for automaticallyestablishing an E-EHR with patient health condition data of amedically-related event that is automatically collected in real-time inproximity to a patient, in accordance with an embodiment of theinvention. The process begins at step 602. At step 604, patient healthcondition data 608 of the medically-related event associated with thepatient may be collected. The step 604 of collecting the patient healthcondition data 608 of the medically-related event may be accomplished byan automatic data collection facility in proximity to the patient suchas those described herein. In embodiments, the automatic data collectionfacility may be a health condition monitor. In an embodiment of theinvention, the health condition monitor may be a handheld blood glucosemonitoring facility 610. The handheld blood glucose meter facility 610may monitor the blood glucose level associated with patient and may bein electronic communication with the prescription administrationfacility (not shown in the FIG. 6). The patient health condition data608 may be raw health condition data that may be transformed to besuitable or used with a medication information database, or it mayinclude patient vital signs, patient blood chemistry results, and thelike.

As described herein, additional data about the medically-related event(which in embodiments may be the patient health condition data 608) maybe fed into a computer 612. As an example, a caregiver might monitor theblood glucose level associated with the patient by using the handheldblood glucose monitoring facility 610 to initiate the process 600. Themonitored information may be automatically read by the automatic datacollection facility. The medication administration facility (110 inFIG. 1) may also prompt the user to enter other relevant data about thepatient's current condition at the time of medication administration.

After the patient health condition data 608 of the medically-relatedevent associated with the patient has been collected at step 604, thehandheld blood glucose monitoring facility 610 may communicate via anelectronic communication, the collected patient health condition data608, to the computer 612 which may represent any of the facilitiesdepicted in FIG. 1 (e.g. prescription management facility 106,prescribing facility 154, outcome database module 124, and the like). Inan embodiment of the invention, the electronic communication may be theInternet. Thereafter, at step 614 the patient health condition data 608and other information may be integrated automatically in real-time withthe patient's EHR facility 618 to establish the E-EHR facility 620 ofthe patient. The step 614 of integrating the patient health conditiondata 608 and other information may be accomplished by using the computer612. The step 614 may further include using the computer 612 totransform the raw health condition data so that it can be integratedwith the patient's EHR. The process ends at step 622.

FIG. 7 illustrates a process and system 700 for automaticallyestablishing an E-EHR with patient psychological data of amedically-related event that is automatically collected in real-time inproximity to a patient, in accordance with an embodiment of theinvention. The process begins at step 702. At step 704, the patientpsychological data 708 of the medically-related event associated withthe patient may be collected. The step 704 of collecting the patientoutcome data 708 of the medically-related event may be accomplished byan automatic data collection facility in proximity to the patient suchas those described herein. In embodiments, the patient psychologicaldata 708 may be collected upon observation of an occurrence of themedically-relevant event. Further, the automatic data collectionfacility may be a machine reader. In an embodiment of the invention, themachine reader may be a handheld barcode reader facility 710. Thehandheld barcode reader facility 710 may read the barcodes on thepackaging of a dosage of medication and may be in electroniccommunication with the prescription administration facility (not shownin the FIG. 7). Further, the patient psychological data 708 may be rawpsychological data that may be transformed to be suitable or used with amedication information database.

As described herein, additional data about the medically-related event(which in embodiments may be the patient psychological data 708) may befed into a computer 712. As an example, a caregiver might scan the codedinformation on a medication packet to initiate the process 700. Thecoded information may be automatically read by the automatic datacollection facility. The medication administration facility (110 inFIG. 1) may also prompt the user to enter other relevant data about thepatient's current condition at the time of medication administration.

After the patient psychological data 708 of the medically-related eventassociated with the patient has been collected at step 704, the handheldbarcode reader facility 710 may communicate via an electroniccommunication, the collected patient psychological data 708, to thecomputer 712 which may represent any of the facilities depicted in FIG.1 (e.g. prescription management facility 106, prescribing facility 154,outcome database module 124, and the like). In an embodiment of theinvention, the electronic communication may be the Internet. Thereafter,at step 714 the patient psychological data 708 and other information maybe integrated automatically with real-time into the patient's EHRfacility 718 to establish the E-EHR facility 720 of the patient. Thestep 714 of integrating the patient psychological data 708 and otherinformation may be accomplished by using the computer 712. The step 714may further include using the computer 712 to transform the rawpsychological data so that it can be integrated with the patient's EHR.The process ends at step 722.

FIG. 8 illustrates a process and system 800 for automaticallymaintaining an E-EHR with administration data of a prescription for apatient that is collected during a medically-related event automaticallyand in real-time while in proximity to the patient. The process beginsat step 802. At step 804, prescription administration data 808 relatedto the medically-related event associated with the patient may becollected. The step 804 of collecting the prescription administrationdata 808 of the medically-related event may be accomplished by anautomatic data collection facility in proximity to the patient such asthose described herein. In embodiments, the prescription administrationdata 808 may be collected upon observation of an occurrence of themedically-relevant event. Further, the prescription administration data808 may be identifiable by the prescription management data in patient'sEHR. Further, the automatic data collection facility may be a machinereader. In an embodiment of the invention, the machine reader may be ahandheld barcode reader facility 810. The handheld barcode readerfacility 810 may read the barcodes on the packaging of a dosage ofmedication and may be in electronic communication with the prescriptionadministration facility (not shown in the FIG. 8). Further, theprescription administration data 808 may be raw prescriptionadministration data that may be transformed to be suitable or used witha medication information database.

As described herein, additional data about the medically-related event(which in embodiments may be the prescription administration data 808)may be fed into a computer 812. As an example, a caregiver might scanthe coded information on a medication packet to initiate the process800. The coded information may be automatically read by the automaticdata collection facility. The medication administration facility (110 inFIG. 1) may also prompt the user to enter other relevant data about thepatient's current condition at the time of medication administration.

After the prescription administration data 808 of the medically-relatedevent associated with the patient has been collected at step 804, thehandheld barcode reader facility 810 may communicate via an electroniccommunication, the collected prescription administration data 808, tothe computer 812 which may represent any of the facilities depicted inFIG. 1 (e.g. prescription management facility 106, prescribing facility154, outcome database module 124, and the like). In an embodiment of theinvention, the electronic communication may be the Internet. Thereafter,at step 814 the prescription administration data 808 and otherinformation may be integrated automatically with real-time into thepatient's E-EHR facility 818 to maintain the E-EHR facility 810. Thestep 814 of integrating the prescription administration data 808 andother information may be accomplished by using the computer 814. Thestep 814 may further include using the computer 812 to transform the rawprescription administration data so that it can be integrated with thepatient's E-EHR facility 818. The process ends at step 820.

FIG. 9 illustrates a process and system 900 for automaticallymaintaining an E-EHR with medication administration data that includespatient identification data of a medically-related event that isautomatically collected in real-time in proximity to a patient, inaccordance with an embodiment of the invention. The process begins atstep 902. At step 904, medication administration data 908 of themedically-related event associated with the patient may be collected.The step 904 of collecting the medication administration data 908 of themedically-related event may be accomplished by an automatic datacollection facility in proximity to the patient such as those describedherein. In embodiments, the automatic data collection facility may be amachine reader. In an embodiment of the invention, the machine readermay be a handheld barcode reader facility 910. The handheld barcodereader facility 910 may read the barcodes on the packaging of a dosageof medication and may be in electronic communication with theprescription administration facility (not shown in the FIG. 9). Themedication administration data 908 may be raw medication identificationdata that may be transformed to be suitable or used with a medicationinformation database, or it may include patient identification data thatmay be collected from a medication container contemporaneously with themedically-related event.

As described herein, additional data about the medically-related event(which in embodiments may be the medication administration data 908) maybe fed into a computer 912. As an example, a caregiver might scan thecoded information on a medication packet to initiate the process 900.The coded information may be automatically read by the automatic datacollection facility. The medication administration facility (110 inFIG. 1) may also prompt the user to enter other relevant data about thepatient's current condition at the time of medication administration.

After the medication administration data 908 of the medically-relatedevent associated with the patient has been collected at step 904, thehandheld barcode reader facility 910 may communicate via an electroniccommunication, the collected medication administration data 908, to thecomputer 912 which may represent any of the facilities depicted in FIG.1 (e.g. prescription management facility 106, prescribing facility 154,outcome database module 124, and the like). In an embodiment of theinvention, the electronic communication may be the Internet. Thereafter,at step 914 the medication administration data 908 and other informationmay be integrated automatically in real time with the patient's E-EHR918 to maintain the E-EHR 918 of the patient. The step 914 ofintegrating the medication administration data 908 and other informationmay be accomplished by using the computer 912. The step 914 may furtherinclude using the computer 912 to transform the raw medicationadministration data so that it can be integrated with the patient's EHR.The process terminates at step 920.

FIG. 10 illustrates a process and system 1000 for automaticallymaintaining an E-EHR with medication administration related data ofmedication that is not administered in a medically-related event that isautomatically collected in real-time in proximity to a patient, inaccordance with an embodiment of the invention. The process begins atstep 1002. At step 1004, medication administration data 1008 of themedically-related event associated with the patient may be collected.The step 1004 of collecting the medication administration data 1008 ofthe medically-related event may be accomplished by an automatic datacollection facility in proximity to the patient such as those describedherein. In embodiments, the automatic data collection facility may be amachine reader. In an embodiment of the invention, the machine readermay be a handheld barcode reader facility 1010. The handheld barcodereader facility 1010 may read the barcodes on the packaging of a dosageof medication and may be in electronic communication with theprescription administration facility (not shown in the FIG. 10). Themedication administration data 1008 may be raw medication identificationdata that may be transformed to be suitable or used with a medicationinformation database, or it may include a medication data that wasprescribed but not administered during the occurrence of the event.

As described herein, additional data about the medically-related event(which in embodiments may be the medication administration data 1008)may be fed into a computer 1012. As an example, a caregiver might scanthe coded information on a medication packet to initiate the process1000. The coded information may be automatically read by the automaticdata collection facility. The medication administration facility (110 inFIG. 1) may also prompt the user to enter other relevant data about thepatient's current condition at the time of medication administration.

After the medication administration data 1008 of the medically-relatedevent associated with the patient has been collected at step 1004, thehandheld barcode reader facility 1010 may communicate via an electroniccommunication, the collected medication administration data 1008, to thecomputer 1012 which may represent any of the facilities depicted in FIG.1 (e.g. prescription management facility 106, prescribing facility 154,outcome database module 124, and the like). In an embodiment of theinvention, the electronic communication may be the Internet. Thereafter,at step 1014 the medication administration data 1008 and otherinformation may be integrated automatically in real time with thepatient's E-EHR 1018 to maintain the E-EHR 1018 of the patient. The step1014 of integrating the medication administration data 1008 and otherinformation may be accomplished by using the computer 1012. The step1014 may further include using the computer 1012 to transform the rawmedication administration data so that it can be integrated with thepatient's EHR. The process ends at step 1020.

FIG. 11 illustrates a process and system 1100 for maintaining a healthinformation dashboard with medication administration data of amedically-related event that is collected in real-time in proximity to apatient, in accordance with an embodiment of the invention. The processbegins at step 1102. At step 1104, medication administration data 1108of the medically-related event associated with the patient may becollected. The step 1104 of collecting the medication administrationdata 1008 of the medically-related event may be accomplished by anautomatic data collection facility in proximity to the patient such asthose described herein. In embodiments, the automatic data collectionfacility may be a machine reader. In an embodiment of the invention, themachine reader may be a handheld barcode reader facility 1110. Thehandheld barcode reader facility 1110 may read the barcodes on thepackaging of a dosage of medication and may be in electroniccommunication with the prescription administration facility (not shownin the FIG. 11). The medication administration data 1108 may be rawmedication identification data that may be transformed to be suitable orused with a medication information database, or it may include themedication, time of administration, dosage, reaction data andadministration of a dosage of medication.

As described herein, additional data about the medically-related event(which in embodiments may be the medication administration data 1108)may be fed into a computer 1112. As an example, a caregiver might scanthe coded information on a medication packet to initiate the process1100. The coded information may be automatically read by the automaticdata collection facility. The medication administration facility (110 inFIG. 1) may also prompt the user to enter other relevant data about thepatient's current condition at the time of medication administration.Further, the medication administration data 1108 may be raw medicationidentification data that may be transformed to be suitable or used witha medication information database.

After, the medication administration data 1108 of the medically-relatedevent associated with the patient has been collected at step 1104, thehandheld barcode reader facility 1110 may communicate via an electroniccommunication, the collected medication administration data 1108, to thecomputer 1112 which may represent any of the facilities depicted in FIG.1 (e.g. prescription management facility 106, prescribing facility 154,outcome database module 124, and the like). In an embodiment of theinvention, the electronic communication may be the Internet. Thereafter,at step 1114 the medication administration data 1108 and otherinformation may be integrated automatically in real time with a datarepository 1118. In an embodiment of the invention, the data repository1118 may be the E-EHR of the patient. The step 1114 of integrating themedication administration data 1008 and other information may beaccomplished by using the computer 1112. The step 1114 may furtherinclude using the computer 1112 to transform the raw medicationadministration data so that it can be integrated with the datarepository 1118.

At step 1120, after the medication administration data 1108 has beenintegrated with the data repository 1118, the medication administrationdata 1108 may be displayed on a dashboard of a user interface tofacilitate the management of health care administration for a facility.In an embodiment of the invention, the step 1120 may be accomplished byusing a computer 1122. The computer 1112 may include: (a) an input dataport to obtain the medication administration data 1108 from the datarepository 1118, (b) a database for storing the obtained medicaladministration data 1108, (c) a Central Processing Unit (CPU) forprocessing the stored medical administration data 1108, and (d) a userinterface to display the processed medication administration data 1108.The process ends at step 1124.

FIG. 12 illustrates a process and system 1200 for managing prescriptionand administration of a medication, in accordance with an embodiment ofthe invention. The process begins at step 1202. At step 1204, a database1208 having information from a reporting source may be accessed. In anembodiment of the invention, the reporting source may include anautomatic data collection facility for collecting medicationadministration data 1210 of a medically-related event in proximity to apatient upon the occurrence of the event such as those described herein.In embodiments, the automatic data collection facility may be a machinereader. In an embodiment of the invention, the machine reader may be ahandheld barcode reader facility 1212. The handheld barcode readerfacility 1212 may read the barcodes on the packaging of a dosage ofmedication and may be in electronic communication with the prescriptionadministration facility (not shown in the FIG. 12). The medicationadministration data 1210 may be raw medication identification data thatmay be transformed to be suitable or used with a medication informationdatabase, or it may include the medication, time of administration,dosage, reaction data, and administration of a dosage of medication.

As described herein, additional data about the medically-related event(which in embodiments may be the medication administration data 1210)may be fed into a computer 1214. As an example, a caregiver might scanthe coded information on a medication packet to initiate the process1200. The coded information may be automatically read by the automaticdata collection facility. The medication administration facility (110 inFIG. 1) may also prompt the user to enter other relevant data about thepatient's current condition at the time of medication administration.

After the information has been accessed from the reporting source atstep 1204, at step 1218, a user selectable dashboard definer may beconfigured to provide user selectable options for defining theinformation from the database 1208. In an embodiment of the invention,the information from the database 1208 may be defined to be presented ina report at a dashboard. In an embodiment of the invention, the step1218 may be accomplished by using a computer 1220. The computer 1220 mayinclude: (a) an input data port to obtain the medication administrationdata 1210 from the data repository 1118, (b) a database for storing theobtained medical administration data 1210, (c) a Central Processing Unit(CPU) for processing the stored medical administration data 1210, and(d) a user interface to display the processed medication administrationdata 1210. Further, at step 1222, a display definer may be configured tooperate in conjunction with the user selectable dashboard definer todefine the format in which the report from the database 1208 may bepresented at the dashboard. The process ends at step 1224.

FIG. 13 illustrates a process and system 1300 for predicting ahealth-related outcome of a patient with a health condition, inaccordance with an embodiment of the invention. The process begins atstep 1302. At step 1304, medication administration data 1308 and patienthealth condition data 1310 of a medically-related event associated withthe patient may be collected. The step 1304 of collecting the medicationadministration data 1308 and patient health condition data 1310 of themedically-related event may be accomplished by an automatic datacollection facility in proximity to the patient such as those describedherein. In embodiments, the automatic data collection facilities may bea machine reader, health monitoring device, and the like. In anembodiment of the invention, the machine reader may be a handheldbarcode reader facility 1312A. The handheld barcode reader facility1312A may read the barcodes on the packaging of a dosage of medicationand may be in electronic communication with the prescriptionadministration facility (not shown in the FIG. 13). In anotherembodiment of the invention, the health monitoring device may be ahandheld blood glucose monitoring facility 1312B. The handheld bloodglucose monitoring facility 1312B may monitor the blood glucose levelassociated with patient and may be in electronic communication with theprescription administration facility (not shown in the FIG. 13).Further, the medication administration data 1308 may include rawmedication administration data that may be transformed to be suitable orused with a medication information database, or may include themedication, time of administration, dosage, reaction data, andadministration of a dosage of medication. Further, the patient healthcondition data 1310 may be raw health condition data that may betransformed to be suitable or used with a medication informationdatabase, or it may include patient vital signs, patient blood chemistryresults, and the like.

As described herein, additional data about the medically-related event(which in embodiments may be the prescription administration data 1308and the patient health condition data 1310) may be fed into a computer1314. As an example, a caregiver might monitor the blood glucose levelassociated with the patient by using the handheld blood glucosemonitoring facility 610 or might scan the coded information on amedication packet to initiate the process 600. The monitored informationor the coded information may be automatically read by the automatic datacollection facility. The medication administration facility (110 inFIG. 1) may also prompt the user to enter other relevant data about thepatient's current condition at the time of medication administration.

After the medication administration data 1308 and the patient healthcondition data 1310 of the medically-related event associated with thepatient has been collected at step 1304, the handheld barcode readerfacility 1310 and the handheld blood glucose monitoring facility 1312Bmay communicate via an electronic communication, the collectedmedication administration data 1308, and the patient health conditiondata 1310 to the computer 1314 which (as in all embodiments herein) mayrepresent or provide access to any of the facilities depicted in FIG. 1(e.g. prescription management facility 106, prescribing facility 154,outcome database module 124, and the like). In an embodiment of theinvention, the electronic communication may be the Internet. Thereafter,at step 1318 the medication administration data 1308, the patient healthcondition data 1310, and other information may be integratedautomatically in real-time with a data repository 1320. In an embodimentof the invention, the data repository 1320 may be the E-EHR of thepatient. The step 1318 of integrating the medication administration data1308, the patient health condition data 1310 and other information maybe accomplished by using the computer 1314. The step 1318 may furtherinclude using the computer 1314 to transform the raw medicationadministration data and the raw health condition data so that it can beintegrated with the data repository 1320.

At step 1322, after the medication administration data 1308 and thepatient health condition data 1310 has been integrated with the datarepository 1320, the medication administration data 1308 and the patienthealth condition data 1310 may be utilized for predicting the heathrecord outcomes. In an embodiment of the invention, the step 1322 may beaccomplished by the outcome analytics facility 1324. The functionalityof the outcome analytics facility 1324 may be similar to the outcomeanalytics facility 128 as depicted in FIG. 3. The process ends at step1326.

FIG. 14 illustrates a process and system 1400 for predicting ahealth-related outcome of a patient with a health condition, inaccordance with an embodiment of the invention. The process begins atstep 1402. At step 1404, medication administration data 1408 of amedically-related event associated with the patient may be collected.The step 1404 of collecting the medication administration data 1408 ofthe medically-related event may be accomplished by an automatic datacollection facility in proximity to the patient such as those describedherein. In embodiments, the automatic data collection facilities may bea machine reader. In an embodiment of the invention, the machine readermay be a handheld barcode reader facility 1410. The handheld barcodereader facility 1410 may read the barcodes on the packaging of a dosageof medication and may be in electronic communication with theprescription administration facility (not shown in the FIG. 14).Further, the medication administration data 1408 may include rawmedication administration data that may be transformed to be suitable orused with a medication information database, or may include themedication, time of administration, dosage, reaction data, andadministration of a dosage of medication.

As described herein, additional data about the medically-related event(which in embodiments may be the prescription administration data 1408)may be fed into a computer 1412. As an example, a caregiver might scanthe coded information on a medication packet to initiate the process1400. The coded information may be automatically read by the automaticdata collection facility. The medication administration facility (110 inFIG. 1) may also prompt the user to enter other relevant data about thepatient's current condition at the time of medication administration.

After the medication administration data 1408 of the medically-relatedevent associated with the patient has been collected at step 1404, thehandheld barcode reader facility 1410 may communicate via an electroniccommunication, the collected medication administration data 1408, to thecomputer 1412 which may represent any of the facilities depicted in FIG.1 (e.g. prescription management facility 106, prescribing facility 154,outcome database module 124, and the like). In an embodiment of theinvention, the electronic communication may be via the Internet.Thereafter, at step 1414 the medication administration data 1408 andother information may be integrated automatically in real-time with adata repository 1418. In an embodiment of the invention, the datarepository 1418 may be the E-EHR of the patient. The step 1414 ofintegrating the medication administration data 1408 and otherinformation may be accomplished by using the computer 1412. The step1414 may further include using the computer 1412 to transform the rawmedication administration data so that it may be integrated with thedata repository 1418.

At step 1420, after the medication administration data 1408 has beenintegrated with the data repository 1418, the medication administrationdata 1408 may be utilized for predicting the heath record outcomes. Inan embodiment of the invention, the step 1420 may be accomplished by theoutcome analytics facility 1422. The functionality of the outcomeanalytics facility 1422 may be similar to the outcome analytics facility128 as depicted in FIG. 3. Further at step 1424, the predicted outputgenerated by the outcome analytics facility 1422 may be utilized tofacilitate prescription management as depicted by pharmacy managementdashboard 1426. The process ends at step 1428.

The FIG. 15 illustrates an exemplary dashboard 1500 to depict amedication administration event for a patient in the Long Term Care(LTC), in accordance with an embodiment of the invention. In anembodiment of the invention, the dashboard 1500 may be populated withthe real-time data from the E-EHR/E-EMR facility (not shown in FIG. 1).Further, at the time of administration of medication, the caregiveradministering the medication to the patient may utilizetechnology-enabled devices such as handheld barcode scanners or otherdevices at the point of administration. The use of handheld barcodescanners may allow real-time capturing of information about the eventsassociated with medication administration. In an embodiment of theinvention, the information captured upon scanning of the barcodes may bedisplayed by the dashboard in an area 1502. Further, the items depictedin area 1504 may also be loaded automatically on the dashboard as thebarcodes are detected by handheld barcode scanners. The items in thearea 1504 may include, but not limited to, patient name, patient ID,location of the patient, and the administrator/caregiver ID. In anembodiment of the invention, the caregiver may confirm the itemsdisplayed in the area 1504 by selecting an option YES as displayed inarea 1510A. In another embodiment of the invention, the caregiver mayreject the items displayed in the area 1504 by selecting an option NO asdisplayed in the area 1510A.

Further, in an embodiment of the invention, after the caregiver hasconfirmed the items displayed in area 1504, an area 1508 may getdisplayed automatically. In an embodiment of the invention, the area1508 may include the medication name that is being administered to thepatient. In an embodiment of the invention, the caregiver may confirmthe displayed medication in the area 1508 by selecting an option YES asdisplayed in area 1510B. In another embodiment of the invention, thecaregiver may reject the displayed medication in the area 1508 byselecting an option NO as displayed in the area 1510B.

Further, in an embodiment of the invention, after the caregiver hasconfirmed the medication displayed in area 1508, an area 1512 may getloaded automatically on the dashboard. The items in the area 1512 mayinclude, but not limited to, the administration date, the administrationtime, the dose administered to the patient, the medication prescription(RX) written for the patient, the RX approved, the information aboutfirst filling of the medication, the information about last filling ofthe medication, the delivery date of the medication, and the like.

Further, in an embodiment of the invention, the dashboard 1500 maydisplay an area 1514 to prompt the caregiver to enter information aboutthe medication administration event. The entered information mayinclude, but not limited to, administrator observations, the details ofthe vitals associated with the patient, the review of prior symptomsassociated with the patient, nay new symptoms after the medication wasadministered to the patient, and the like.

Computer-based or electronic order entry may guide doctors, nurses, andother authorized staff through quick and efficient electronic orderingof medication, related treatment, and clinical care services required bypatients. The clinical care services may include diet, nutrition,therapy, lab services, and the like. This in turn may streamline theinteraction between the pharmacy/medication supply units and healthcareentities. Time consumed in placing the orders via conventional mediumssuch as phone calls and faxes may be reduced. In addition, automated,real time alerts and warnings may be issued regarding allergies,clinical interactions, dosage, duration issues, and genericsubstitutions. Further, online help regarding medicines and regulatorycompliance may also be offered by the system. This process may improvepatient safety and reduce medication errors through increased orderaccuracy. Further, less time may be spent on ordering and chasing downincomplete, inaccurate, or missing orders. Thus, the time saved throughuse of an automated system may be utilized in better patient care.

Referring again to FIG. 1, various facilities for managing and/ortracking different prescription management events, such as validation,selection, dispensing, marking, and delivery are depicted among severalother facilities and features of the invention. A prescriptionmanagement facility 106 may include a validation/selection facility 102,a dispensing and marking facility 104 and a delivery facility 108 apartfrom other facilities as shown in FIG. 1. These facilities may beconfigured to receive/send real time event tracking data with otherpatient medical related facilities. Real time tracked events fromvarious medical related event streams may be utilized by theprescription management facility 106 for real time and automatedentries, processing, and checks. Medical event streams may includeinformation from prescribing units, care planning facilities,laboratories & imaging centers, insurance & payments units,rehabilitation and long term care facilities, electronic medical recordrepositories, dashboards and databases, third party sites, healthcarefacilities, and the like.

The prescription management facility 106 may include one or moreinterfaces that may facilitate entry of order data. Orders associatedwith the various prescription management services may be placed via anyof several mediums including submitting an order form over the Internet,accessing the interface through public and/or private kiosks, submittingorders (e.g. prescriptions) through mobile phones (SMS and calls),electronic fax, system-to-system order transfer, wireless portabledevices (e.g. dedicated prescription management devices), and the like.For example, a nursing home care provider secure website may be designedwherein orders for patients may be entered by physicians, medicalconsultants, nurses, healthcare staff, and the like. The prescriptionmanagement interface(s) may be configured with security provisions thatmay restrict orders from being entered and/or discontinued except by anurse practitioner, doctor or a specialist and not by any other facilitystaff or employee.

The prescription management facility 106 interface may include agraphical user interface for order entry. In such an interface, a usermay utilize various buttons, list boxes, and text boxes for entering andmanaging order data. In order to confirm the validity of data entered,the software underlying the graphical user interface may validate theentered data. For example, if the age of the patient may only berecorded in numeric format, JavaScript code embedded in the interfacesoftware may disallow the entry of non-numeric data into the age field.Likewise, other validation may be embedded into the graphical userinterface to ensure the validity of the data.

Orders entered in the prescription management facility 106 may allowselection and/or verification of record through an interface such asGUI. As described above, the validation and verification of orderentered may be performed in real-time during entry. For example, anursing home portal may contain patient profiles collected from variousdashboards, electronic medical records, databases, and the like. Accessto the portal may require user authentication.

In addition to real time validation of order data entered into datafields of a user interface, user authentication may be employed and maybe provided in the form of login credentials, encrypted passwords,voice-based authentication, physical authentication, biometric (e.g.,use of eye scan or finger prints), and other types of user-basedauthentication. To further ensure security of patient records, an orderentered by a medical practitioner may require authenticating the medicalpractitioner for a particular patient by validating other aspects suchas referrals, signed patient agreements to be treated, and the like. Inaddition, medical order entry may require selection of an order typethrough menus or tabs that may be enabled for the patient/providercombination and may correspond to various parameters, such as neworders, admissions record, prior authentication, history, allergies,physician's orders, and the like.

Validating a physician's orders may include requiring access to detailedinformation of the patient such as current diagnosis and orders,discontinued orders, allergies and reactions, and the like. Althoughthis information may be collected in real time from the prescriptiondesk of the physician or medical consultant, a judicious, error-free,quick, and responsive method of collecting such real time informationmay be aided by using patient identification (ID) numbers or codes. Forexample, there may be approx. 250 patient entries with the name AllenSmith known to the pharmacy management facilities. However, when AllenSmith's ID No. SYS2244 is used, only the medical information thatcorresponds to a particular Allen Smith may be fed in to theprescription management system to access detailed patient information.Validation may rely on information in the selected profile (e.g., thepatient has been prescribed two dosage of Aspirin EC oral tablets andone dosage of Azathiocrine—50 mg tablets, to be consumed once a day at8:00 AM in the morning) to help avoid potentially dangerousdiscrepancies in prescription management. In this example, newprescription information (e.g., received from a physician's hand-heldprescribing unit) may indicate use of a particular drug; however, theexisting prescription information may indicate potential adverse sideeffects due to this combination of medications. In such a case,real-time validated information may be sent to the physician's hand-heldprescribing unit as an alert to possibly adjust the prescription beforethe patient leaves the office. Alternatively, the validated informationmay be sent as a reminder to a nurse at the time of administration toensure that the proper precautions have been taken to allow thecombination of medications in the patient.

The prescription management facility 106 may rely on informationreceived from prescribing units, laboratories, imaging units, and thelike to ensure a prescription is validated. The prescription managementfacility 106 may affect correlation between the tests, results, dosagefrequency (high, medium, low), and/or efficacy of the prescribed drugfor validation. For example, data from imaging tests may indicate a verylow bone density in a patient who has been prescribed high dosage ofsteroids for a problem unrelated to her bones. The correlation of theimaging data with the new prescription for steroids may indicatepotential further deterioration of the patient's bone density; thereforealerts and/or reminders may be sent to the concerned entities (e.g.doctor, patients, prescription management facility, and the attendants)regarding these potential damaging adverse effects.

Similarly, real time information may be collected from third partysources, pharmacy planning units, regulatory databases, and the likeregarding the interaction, effects, and detailed reviews of variousdrugs and their interaction. This may be helpful in managing adversereactions of various medicines on patients as well aseducating/informing healthcare professionals and doctors about newfindings on the drugs and their interaction. This process may bespecifically significant in cases where new drugs for chronic orpandemic diseases are prescribed, consumed, and tested. This may beexplained with the help of the following example.

During a pandemic contagious virus spread, a particular medication ‘X’may be prescribed. Real time information regarding the usage, effects,and disposal (complete medication cycle) may be collected and analyzedby the pharmacy planning and regulatory units. Data may be collectedfrom nursing care centers, hospitals, patient responses, clinics, andthe like that indicates that this medicine ‘X’ results in certain sideeffects such as nausea, diarrhea, and extreme body ache. Clinical trialsand analysis may recommend that these side effects are suppressed if themedicine ‘X’ is supplemented with medicine ‘Y.’ Information fromclinical trial laboratories may be sent in real time to the variousfacilities including validation and selection facility of theprescription management facility. Upon validation of the ‘order entry’form for a patient, a safety check may be conducted to ensure thatmedicine ‘X’ and medicine ‘Y’ are prescribed together for any reportedcase of the above disease. Thus, the validation and safety checks may bein real time and actionable.

The prescription management facility 106 may also include automatedinsurance coverage checks. Information regarding the patient's insuranceplan, medicines and treatments covered under that plan, and paymentoption details may be accessed in real time by the prescriptionmanagement facility 106. Verification of insurance information may besignificant since coverage of patients within any particular insurancecompany may vary. As shown in FIG. 1, event information from insuranceplanning and insurance and payments facilities may be collected in realtime and shared with the prescription management validation andselection facility 102. The prescription management facility 106 mayvalidate that a medication being prescribed to a patient is covered bythe patient's policy with the insurance company to avoid use ofnon-covered medications that may result in phenomenally high expensesfor the patient.

In another example, information regarding the validity and paymentdetails for a patient's insurance policy may be shared with themedication facility. In case, the last premiums have not been paid, thepatient or his/her caretakers may be informed regarding the same. Incertain cases, provisions may be made to facilitate payments from theclosest kiosk within the healthcare facility.

The prescription management facility 106 may also include automatedinsurance claims processing checks. The information for prescribedmedications or indicative symptoms of a disease may be shared with theinsurance processing and payment facility. Other information that may beshared may be frequency and duration of the treatment, professionalinformation of the surgeon or healthcare, percentage of payment to beborne by the insurance company and the like. This information may beautomatically compared by the prescription management facility 106 withinformation supplied by the patient and any discrepancy between the twomay be reported. This automatic process may speed-up the portion of theprescription management cycle related to insurance claims processing.

In an embodiment, the system may select and validate order informationfor various information fields such as order type, medication, dosage,frequency, day's supply, dispensing quantity, special instructions,physician information, etc. This information may be significant infacilitating automated medication dispensation processes. For example,it may be pertinent to correctly calculate the day's supply ofmedication and its dispensing quantity based on the total length of thephysician's prescription.

Duplication of orders may be recorded in real time. In response to anyduplicate entry of order an error message may be displayed, alerting theuser of a duplicate entry. Order information may also be validated forpossible duplicate orders.

The prescription management facility 106 may include inventorymanagement capabilities in that the system may match a prescribed drugwith the pharmacy inventory. Discrepancies, such as low inventory,unavailability of a drug or its substitute, and the like may result inan order for this particular drug being prepared. Through properinventory management, a medication dispensing process associated withthe pharmacy management facilities may be a just-in-time dispensingprocess that may judiciously assess the quantity and time of deliveryfor orders. For a healthcare facility, the orders may also be dispensedas per the internal organization or layout. For example, separate ordersmay be prepared for separate floors (e.g., ground, first, second, etc.)or by nursing station (pediatrics, dental, gynecology, etc.) or by typeof patients (inpatient or outpatient wards) Such an automated medicationdispensing process may reduce the dispensing time required, mitigatefinancial risk and administrative burden from unused quantities, andminimize wastes and unnecessary expenses, thereby providing an efficientsystem capable of meeting patient needs.

Automation, accuracy, and efficiency may be enhanced with bar codedpatient medicine packs that may be utilized in combination withtechnology enabled medicine pack bar code readers by healthcareprofessionals (e.g., nurses) to administer and track in real timemedications and treatments for each patient. The bar coded med packs mayensure safe, proper, and timely administration of drugs to patients.These bar codes may be read with the help of scanners, camera-basedmobile phones, or any other wired or wireless device with scanning orimaging capabilities. The data encoded in the bar code, matrix code,line code, 1D code and the like may be a unique prescription identifierthat also identifies essential attributes of the prescription. Forexample, the code may include a unique prescription identifier and aunique dosage identifier. This information may be used to lookup furtherdetailed information about the planned medication administration event,such as the medication, the dosage, the time of administration, thepatient, the expected location of the patient, and the like.Alternatively, more extensive information may be coded into the label oridentifier that may include the patent name and ID for example, to allowfor manual or semi-automated verification of the patient data by thenurse at the time of administration without the need of a networkconnection to a facility such as the prescription management facility106.

The prescription management facility 106 may handle automated refillorders and refill alerts to further improve prescription managementefficiency.

The prescription management facility 106 may include a therapeuticequivalent facility which accepts electronic medication orders andsuggests therapeutic equivalents. Drug products classified astherapeutically equivalent may be substituted with the full expectationthat the substituted product will produce the same clinical effect andsafety profile as the prescribed product. In embodiments, drug productsmay be considered to be therapeutically equivalent if they meet thesecriteria: they are pharmaceutical equivalents (contain the same activeingredient(s); dosage form and route of administration; and strength.);they are assigned by FDA the same therapeutic designates a brand namedrug or a generic drug to be the Reference Listed Drug (RLD), andassigns therapeutic equivalence codes based on data that a drug sponsorsubmits in an Abbreviated New Drug Application to scientificallydemonstrate that its product is bioequivalent (i.e., performs in thesame manner as the Reference Listed Drug). The therapeutic equivalentfacility may contain a library of such therapeutic equivalents andsuggests them to the prescribing professional upon order entry based onfor example, whether the proscribed medication is on the patient'sinsurance formulary.

Real time tracking of medical events may be facilitated with the help ofa record system stored in a database. For this purpose, one or moredatabases may be maintained, such as a distributed database. Adistributed database model may facilitate replication of data so thatfailure of one of the nodes may not affect the performance of theoverall system (fault tolerance) and as a result, the data may beavailable 24×7.

Data stored in the distributed database may be fragmented horizontally,vertically or in a mixed mode, i.e., involving both horizontal andvertical fragmentation for increasing the retrieval of data. Forexample, the records for Pittsburgh may be horizontally fragmented andstored in one of the distributed database nodes located at Pittsburgh.By horizontally fragmenting the records corresponding to Pittsburgh, therecords for Pittsburgh may be placed in a database node located atPittsburgh. Usually, patients and doctors residing in Pittsburgh may beserviced from the database node located in Pittsburgh. Recordscorresponding to other locations may be also be maintained at eachlocation; that is, a database node.

Data stored in the databases may include medical content in the form ofprescription by a doctor, surgical reports, pathological tests,patient's medical history, and the like. While legacy data may be storedin the database for record keeping, this data may be continuouslyupdated with real-time data received at the database from various otherfacilities. Further, the database may be enabled to update informationin real-time. In an embodiment, the database may be an OLAP OnlineAnalytical Processing.

The database may include capabilities of transforming the data into arequired format. For example, data may be received from a number offacilities such as an Mill facility. This may require transformation toan acceptable format before it may be stored in the database. In thisaspect, the database may itself include software facilities fortransforming data into an acceptable format. Alternatively, data mayundergo a transformation in a transformation facility for converting thedata into a format acceptable for storing the same in the database.

The database may provide one or more streams to registered data usersregarding medical events. For example, an RSS feed may be provided, andregistered users may receive medical event data related to theirpatients, latest trends in medical sciences, drug developments,administration of new drugs to patients and their outcomes and the like.

Data security may be ensured in the medical facility throughauthentication requirements. For example, an entry for a record to bestored in a database may only be made upon proper authentication of auser along with an entry of his personal as well as log in details. Inanother embodiment of a fully automated tracking and record keepingdatabase management system, unique log in credentials may be provided tousers who are registered with the medical facility and correspondingdetails of users are gathered and stored in a separate database onceduring registration. Any subsequent correspondence from a registereduser may be accompanied with certain security checks to confirm alreadystored details of the registered users. Further, various records of thedatabase may be encrypted for a secured access by an authorized andintended person only. Encryption of the records of a database in themedical facility implements an authorization protocol that can bedecrypted by a specific secured key only. In an embodiment, a token maybe issued to a user on any type of association with the database thatmay enable further processing and assist in track keeping of databasecommunications. The token, in an embodiment, may be generated using anautomated system in the form of an email.

The information stored in databases may be utilized for generatingreports, sheets, updates, and sending auto-generated emails to intendedrecipients. Such reports, updates and emails may be customized for aparticular person or a section of people. Further, such customizedreports and emails may be generated periodically or on demand. Thereports and emails may depict simple medical information in textual formfor a period of time, statistical analysis based on data, forecasteddetails pertinent to healthcare, medical suggestions and the like.

The pharmacy or medication unit may be either in-house or remote. Thein-house pharmacy system may be an automated, self service dispensingsystem that may be located in the vicinity of the healthcare facility.The system may be endowed with sufficient stocks (e.g., 350 SKUs) tomeet immediate patient medication needs at any given time. In othercases, remote pharmacies may interact with the healthcare facility viawired or wireless networks. The medications and the packaging may besupplemented with electronically readable information. Theelectronic/machine readable information may be a RFID tag, barcode,optical disk, and the like.

Remote dispensing of prescriptions may be supported by automateddispensing machines such as in-facility kiosks, third party homedelivery chains, and the like. Remote dispensing may include security toensure proper authentication of the recipient through such means asidentifiers, passwords, finger scan, and the like. Further, themedications usage from the dispenser may be tracked using tags,scanners, or sensors.

Similarly to integrated prescription dispensing facilities, remotedispensing means may be able to detect nearly exhausted supply levels.

In accordance with embodiments of the present invention, smart phonesand other similar wired or wireless devices may be used for implementingthe given invention. Similar to a web application, the present inventionwhen enabled on a smart phone or may be used for various functions forprescription management such as order entry, safety checks and alerts,insurance coverage checks and claims processing, medicationdispensation, care planning, and the like. Smartphone applications maytake advantage of high resolution interfaces available on some smartphones. The interfaces may be graphical, tactical, touch-based,web-based, gesture-based, intelligent user interface, motion trackinginterface, multi-screen interface, text user interface, voice userinterface, and the like. A prescription management smartphoneapplication may interact with various databases such as electronicmedical records database, regulatory database (e.g., FDA), laboratoriesand imaging database, physician's health records, and the like.

A smartphone application may alternatively be available for patient useand may be used to create medication alerts for a patient in real time.For example, information about a patients purchase an over-the-countergeneric drug may be captured in real time and sent to the prescriptionmanagement facility 106 where validation may determine that otherprescriptions that the user it taking may result in a severe reaction toa composition in the purchased drug. This information may be immediatelybroadcasted in real time to the user's smartphone application or as anautomated voice call and/or a text message. In addition, informationprovided in the alert may suggest substitutes that the user maypurchase.

The prescription management facility 106 may include a physicianordering facility that may capture prescription behaviors and/orpractices of a physician to help improve validation, quality ofprescriptions, and the like. In an example, a physician may routinelyask his nurse to submit prescriptions for him. The system may recognizethat prescriptions coming from a variety of nurses in the doctor'soffice are all authorized by the same doctor and may use thisinformation to automatically associate prescriptions from these nurseswith this doctor.

In-patient facilities (hospitals, nursing homes, long term care,residential rehabilitation centers, and the like) typically collect newpatient information during a patient admission process. A pharmacymanagement facility may include built-in capabilities to capture and/orreceive complete patient information from a facility admission module,thereby reducing the opportunities for typographical or other human dataentry errors. In addition, admissions modules often automaticallycollect medical history information (from the patient, a representative,or a medical record). This information can be processed through thebuilt-in admissions information sharing modules and presented in a formthat is most useful to the prescription management, dispensing, andvalidation facilities.

The invention may further include a prescription administration facility110 to facilitate proper administration and real time data capture ofprescription administration information. By utilizing technology enableddevices such as handheld or other devices at the point ofadministration, important information about the events associated withand immediately after administering medications may be captured in realtime. Such technology enabled devices may also benefit theadministration process by providing real time data and contextualinformation for the person performing the administration (e.g. apatient, nurse, technician, physical therapist, or other care provider).The prescription administration facility 110 may access or communicatewith a data center that may provide information from any of a variety ofmedical information related sources as depicted in FIG. 1. Such accessmay typically be via a wireless connection.

In an exemplary case, the wireless connectivity may be Internet. Inother exemplary cases, the wireless connectivity may be WI FI, WiMax,Bluetooth, Infrared and other similar types of wireless technologies. Inan embodiment of the invention, the wireless connectivity may be asecured connectivity. The security may be of different types includingWireless Encryption Protocol (WEP), WI FI Protected Access Pre SharedKey (WPA-PSK), MAC address filtering and the like. WEP works byestablishing a shared key between the clients (network cards) and thewireless router, then using the key to encrypt and de-encrypt the datapassing between them. WPA-PSK is a WI FI standard that improves upon thesecurity features of WEP. To use WPA-PSK, a shared key or “pass phrase”is set. Using Temporal Key Integrity Protocol (TKIP), WPA-PSKautomatically changes the keys at a preset time interval, thus makingbreach of security difficult. In MAC address filtering, each networkadapter or card (wired or wireless) has a unique number assigned to itcalled a MAC address. As a result, if a wireless USB adapter is pluggedinto a computer, it will show its own MAC address when connected to theInternet.

The technology enabled prescription administration facility 110 mayfacilitate providing bedside prescription administration that mayfurther facilitate capturing all care giver observations and clinicalevents performed as part of the prescription administration. Theprescription administration facility 110 may further providestep-by-step guidance and alerts for working with and providing care forpatients. The prescription administration facility 110 may further guidenurses through administering and documenting medication and treatmentfor each patient. Patient-specific medication packs provided from theprescription management facility 106 may include bar-codes that mayfacilitate bedside verification for all medication and treatment at themoment of administration. As described herein, the information capturedon the bar-code label or other identifier may include a uniquedosage-specific identifier that, when presented to the prescriptionmanagement facility 106, can be used to lookup all of the essentialpatient information. Alternatively, essential patient information mayalso be encoded in the identifier so that a caregiver may manually orsemi-automatically verify patient information without the need of anetwork connection to the prescription management facility 106. Theprescription administration facility 110 may also facilitate automaticcollection of data for documentation of all medication and treatmentadministration activities using bed-side readers, scanner, proximitydetectors, and the like. The bed-side data capture facility 110 mayinclude a plurality of visual and/or audible prompts to which a nurse orother caregiver may response to capture information that my not bereadily captured automatically in all instances (e.g. coloration ofpatient's skin, condition of patient's hair, and the like). In anembodiment of the invention, the prescription administration facility110 may collect data that includes, without limitations,medically-related event, healthcare related events, patient healthcondition data, patient physical activity data, patient treatment data,patient oral consumption data, patient visitor data, patient outcomedata and patient psychological data. Further, the prescriptionadministration facility 110 may include a real-time data integrationfacility that may provide integration of this collected data with theE-EHR/E-EMR facility 118. In an example, the patient health conditiondata may include the patient's vital signs collected automatically atthe time of medication administration and/or at other times, such asthrough the use of wireless body monitors that may be in wirelesscommunication with the HPDMA 100. In another example, the patientphysical activity data may include patient's position and movementfacilitated by the caregiver and patient sleep data. In yet anotherexample, the patient treatment data may include bathing, dressing, woundcare, bed position adjustment, physical therapy, psychotherapy andpatient position adjustment. In yet another example, patient oralconsumption data may include foods prepared for the patient and foodsconsumed by the patient, fluids consumed by the patient andnon-prescription medications consumed by the patient.

The prescription administration facility 110 may also collect medicationadministration data from coded information of the packages ofmedications, for example, the medication pillow packs. The medicationadministration data from the medication pillow packs may include patientidentification information. The prescription administration facility 110may also collect data for the medication that was prescribed but notadministered to the patient.

Further, an electronic history of each activity and dosage forautomatic, anytime reporting and documentation may also be achieved withthe prescription administration facility 110. To help with ensuringproper patient communication and care is provided by all care givers,the prescription administration facility 110 may access patient recordsto automatically display patient pictures, medication pictures andadditional information that may aid verification and prescriptionsafety. The prescription administration facility 110 may further provide24×7 access to pharmacy experts through wireless connectivitycapabilities described herein.

Further in an embodiment of the invention, prescription administrationfacilities may include integration of the computing device with ascanner for scanning barcodes. The barcode scanning recognitiontechnology may capture medication data, patient data (e.g. throughscanning of a wristband, or other identifier), administrator data (e.g.through scanning of the administrator ID badge), and the like in realtime and allow the caregivers to chart and maintain all critical patientinformation as they administer. At the time of prescriptionadministration, the administering professional using the prescriptionadministration facility 110 may scan barcodes, which will populatevarious fields in the prescription administration tracking records.Alternatively, or in conjunction with the scanning, the data relating toadministration may be entered into the prescription administrationfacility 110. In embodiments, once the information is entered, and priorto administration, the information may be validated such as throughcommunicating with the prescription management facility 106 dataservers. In an exemplary case, the barcode scanner (hereinafter thebarcode scanner will be interchangeably referred to barcode reader) maybe a handheld scanner. The handheld scanner may have a handle andtypically a trigger button for switching on the light source associatedwith the scanner.

The barcode scanner may work with different technologies. In an example,the barcode reader may be a Pen-type reader. The Pen-type readersconsist of a light source and a photodiode that are placed next to eachother in the tip of a pen or wand. To read a bar code, the tip of thepen moves across the bars in a steady motion. The photo-diode measuresthe intensity of the light reflected back from the light source andgenerates a waveform that is used to measure the widths of the bars andspaces in the bar code. Dark bars in the bar code absorb light and whitespaces reflect light so that the voltage waveform generated by the photodiode is a representation of the bar and space pattern in the bar code.This waveform is decoded by the scanner.

In another example, the barcode scanner may be a laser scanner. Laserscanners work the same way as pen type readers except that they use alaser beam as the light source and typically employ either areciprocating mirror or a rotating prism to scan the laser beam back andforth across the bar code. As with the pen type reader, a photodiode isused to measure the intensity of the light reflected back from the barcode. In both pen readers and laser scanners, the light emitted by thereader is rapidly varied in brightness with a data pattern and thephotodiode receive circuitry is designed to detect only signals with thesame modulated pattern.

In yet another example, the barcode reader may be a Charge-CoupledDevice (CCD) reader. The CCD readers use an array of hundreds of tinylight sensors lined up in a row in the head of the reader. Each sensormeasures the intensity of the light immediately in front of it. Eachindividual light sensor in the CCD reader is extremely small and becausethere are hundreds of sensors lined up in a row, a voltage patternidentical to the pattern in a bar code is generated in the reader bysequentially measuring the voltages across each sensor in the row. Thedifference between a CCD reader and a pen or laser scanner is that theCCD reader is measuring emitted ambient light from the bar code whereaspen or laser scanners are measuring reflected light of a specificfrequency originating from the scanner itself.

In yet another example, the barcode reader may be camera based readers.The camera based readers use a small video camera to capture an image ofa bar code. The reader then uses sophisticated digital image processingtechniques to decode the bar code. Video cameras use the same CCDtechnology as in a CCD bar code reader except that instead of having asingle row of sensors, a video camera has hundreds of rows of sensorsarranged in a two dimensional array so that they can generate an image.

In yet another example, the barcode reader may be Omni-directionalbarcode scanner. The Omni-directional scanning uses a series of straightor curved scanning lines of varying directions in the form of astarburst, a lissajous pattern, or other multi-angle arrangement areprojected at the symbol and one or more of them will be able to crossall of the symbol's bars and spaces, no matter what the orientation.

Further in embodiments of the invention, the barcode scanner may beconnected to the computing device via a serial interface, a proprietaryinterface, a keyboard wedge, a Universal Serial Bus (USB) connector, anywireless network and the likes.

To ensure proper prescription administration, a variety of validitychecks may be performed, some of which have already been describedherein. Information related to the prescription administration that maybe validated include information such as the number of times themedication is to be provided to the patient in a day, the dosage of themedication, the details of the personnel associated or the responsiblewith the patient, and the like. Validation may fail if any criterionestablished relative to these validation points is not met. In anexample, if a nurse scans a prescription medicine dosage pack for apatient but during validation, the system determines that the patienthas already received a maximum daily dose within the last 24 hours, thesystem may alert the nurse to the potential overdose. This validationmay be possible because the prescription administration facility 110 mayallow real time access to medical record information and prescriptioninformation provided by the prescription management facilities and otherfacilities as depicted in FIG. 1. Validation may also involve sendingreal time information collected during bedside preparation foradministration to the prescription management facility to ensure thatthere has not been a change to the patient's medication that may impactthe administration to be performed. In embodiments, this is madepossible by the real-time connectivity between the relevant facilitiesof the system described in FIG. 1, which in this case includes theprescription management facility and the prescription administrationfacility. If so a stop order or the like may be communicated by themedication management facility and displayed via an interface on theprescription administration electronic device. In this way, the systemmay prevent the administration of discontinued medications and ensurethat the correct medication and dosage is being administered at theright time. Under certain conditions the system might require thecaregiver to uniquely identify himself or herself using a plurality ofidentification methodologies. The collected identification informationmay be recorded and stored to ensure compliance with regulations andprovide tracking information for the caregiver that administered thetreatments or care.

Data collected may include actual administration times, drugadministered, dosage, patient, personnel who performed theadministration (e.g. to track when a shift change has resulted in adifferent nurse administering a prescription that the one who preparedit from the pharmacy or medicine cart), timing and route ofadministration (e.g. a refrigerated prescription may be dispensed from arefrigerated storage but may not be administered for several minutes oreven hours due to limited staffing or large patient load or the like),therapeutic equivalent considerations, and the like.

The prescription administration facility 110 may also provide alerts forthe refills by scanning the barcodes. This alert may notify the pharmacythat a refill for a particular medication is required. Further, theprescription administration facilities may calculate the expiry datesfor the bulk items. A bulk item or non-cycle medication is a medicationthat is not machine dispensable for each dosage, the bulk items mayinclude gels and creams. The scanning of barcodes may further providethe medications a list. The list may include information about whichmedication is to given at what time and the like.

Further in an embodiment of the invention, the HPDMA 100 may allowfeeding of a Minimum Data Set (MDS) with the health status of eachpatient. The MDS for each patient may be coupled to the care planningfacility 152 to develop individual care plans that outline theappropriate interventions required to address specific ailments,handicaps, and other health care needs. In an embodiment of theinvention, the coupling may be achieved by integrating the medicationadministration record (MAR) of the patient into the MDS of the patient.Further, a portion of the patient care plan may be devised using aninterface associated with the prescription management facility 106. Thecare plan may provide a road map to guide all the caregivers who areinvolved with the patient or residents care. The MDS may provide acomprehensive assessment of each patient's functional capabilities andmay help care providers (e.g. nursing home staff) to identify healthproblems associated with the patient. A list of deficiencies with thepatient's overall health and well being may also be generated andrecorded in association with the MDS. On the basis of the healthproblems, a proper plan for the patient may be devised for resolving thehealth problems or improving the health of the patient.

The HPDMA 100 may also allow measuring and tracking of the clinicaloutcomes for the patient which may allow devising of effective healthcare plans for the patient. Further, a decision making tool may beprovided to the health care specialist to design the health care planfor the patient. This decision tool may obtain data associated with thepatient from the prescription management facility 106 and the medicationadministration facility 110. The decision tool may also obtain anecdotaldata, and the narrative data provided by the nurses in the form of theirnotes and the ADL information. In an embodiment of the invention, thedecision tool may also capture the nursing notes directly from the MARcharts. Further, clinical algorithms may be provided that may suggestchanges in the patient's medication. These changes may include change indosage of the medication, change in the therapy and the like. Thesechanges may be based on the clinical outcomes of the current medicationand therapies administered to the patient. Further, the differentclinical outcomes may be for pain management, treatment and preventionof pressure ulcers or bed sores, disease specific behavior managementrelated to using anti-psychotic drugs or diabetes programs. Each type ofclinical outcome may require focus and collection of different kinds ofdata associated with the disease and its outcome. Further, each type ofdata may be data object for the MDS. The HPDMA 100 may also providedifferent types of physiological sensors to populate data into the MIDS.

The HPDMA 100 may also allow tracking of the electronic ordering formfor ordering the medication associated with the prescription managementfacility 106 for populating the MDS. The MDS may record different typesof prompts that may occur while filling up the electronic order form.The HPDMA 100 may also allow tracking of the medication administrationfacility 110 for populating the MDS. The MDS may record different typesof prompts that may occur while administrating the medication to thepatient. The prompts may include warnings and alerts. The HPDMA 100 mayalso allow tracking of the documentation module for populating the MDS.

Further in embodiments of the invention, the populated MDS may becombined with additional features to facilitate implementation ofspecial instructions or to act as reminders. In an example, a voiceactivated head set may be provided to the patient in LTC; this headsetmay react to verbal inputs and record what is said aloud by the patientand this data may be added to the MDS. In another example, a nurse alarmsystem may be provided to the LTC patient that alerts the nurse at anurse station that the patient needs to be attended to. In yet anotherexample, wound management tools may be linked to the MDS. This woundmanagement tool may be in the form of a mobile device application(“App”) that is able to scan the patient's wounds and the image may betransmitted to the health care specialist who may then provide advice onhow to better manage the healing process of the wound. This applicationis useful in situations where the patient care facility is remotelylocated and the specialist is not readily available. In addition, insome instances the second opinion of another medical professional may berequired and in this event, an App may be useful in transmitting reallife images of the condition of the patient.

In yet another example, the MDS may be linked with pain managementtools. The relative intensity of the pain being felt by the patient whomay be terminally ill may be recorded and transmitted to the MDS; thisdata may then be accessed by the nurses and/or attending doctors and thepain management medication may be altered accordingly. In thisapplication, the dosage of the pain medication will correspond exactlyto the condition of the patient on that day and excess or inadequatedosages based on conditions recorded a few days ago may be avoided.

Further in embodiments of the invention, the MDS may be populated withdata received from the sources of the E-EHR facility 118. The sources ofE-EHR facility may include, but not limited to, the prescriptionmanagement facility 106, the prescription administration facility 110,the patient attributes and events facility 112 and outcome eventsfacility 114. The MDS may also be populated with the new data elementswithin the E-EHR facility 118. The HPDMA 100 may further provide data orformat conversion techniques that may support recording of data in theMDS directly from the existing records in the E-EHR facility 118.

In an example of MDS data collection, a US federally mandated MinimumData Set of data to be collected periodically from health carefacilities to qualify for Medicare/Medicaid reimbursement has beendefined. Such an MDS is generally collected first when a patient entersa facility in which MDS is required and then again periodically as partof a Resident Assessment Program. The methods and systems of datacollection, real-time collection and exchange, and the like as describedherein for the HPDMA 100 may contribute to the effective and thoroughcollection of MDS at any of a wide variety of patient touch points asdescribed herein and elsewhere. The use of technology enabled datacollection device to collect real-time data in proximity to patients mayalso facilitate the collection, roll-up and transmission of MDS to Stateand/or Federal authorities (e.g. at the Centers for Medicaid andMedicare Services (CMS)).

The healthcare management platform 100 may provide recording andcharting of different kinds of information and events occurring in thesystem. In an embodiment of the invention, this recording and chartingof information may be achieved by entering data in various chartselectronically. The HPDMA 100 may also provide a plurality of differenttypes of charts that may include information collected from a widediversity of important and potentially very different informationsources, some of which are described herein.

In an embodiment of the invention, the HDMA 100 may provide a reportingcapability that may facilitate generating an Electronic MedicineAdministration Record (e-MAR) chart. A Medicine Administration Recordmay include information about the patient and his/her condition (name,DOB, ID number, personal physician, allergies, general diagnosis); thename of the medication, the medication abbreviation or code, the datethat the medication was started, the diagnosis/purpose/conditionrelevant to the medication, the strength of the medication, the dosageform (e.g. pills, drops, ointment, other), the dose, the route ofadministration (mouth, ear, eye, intravenous, etc.), the frequency ofadministration, the prescribed administration times, the length of timethat the prescription is to be given, and any special precautions orcontraindications; name of person administering medication; and a chartof medication over time. The e-MAR chart may be configured by accessingone or more databases (e.g. E-EHR, outcome database, and the like asshown in FIG. 1) having information from a plurality of reportingsources. In an embodiment of the invention, the reporting sources mayinclude, without limitation, the prescription management facility 106,the medication administration facility 110, the patient attributes andoutcomes facility 112, the E-EHR facility 118, and other medicalinformation and patient care facilities. In an embodiment of theinvention, the e-MAR chart may depict data that is directly aggregatedfrom the prescription management facility 106 and the medicationadministration facility 110. Further, when a health specialist or aphysician enters a medical prescription through the electronic orderfacility provided by the prescribing facility 154, certain of thatmedical prescription data may get recorded into an e-MAR chart, forexample contraindications and duration of prescription. The e-MAR chartmay also be updated with medical prescription validation data that maybe obtained in real time for the patient from aspects of the HPDMA 100,such as the marking and dispensing facility 104.

The invention allows for a typical MAR to be enhanced with additionalinformation. In embodiments, the e-MAR chart may further depict a recordof the time at which the nurse is notified about the medication for thepatient, where the medication is available and when the nurse wasinformed. The medication may be available at the floor, the wing or theonline medication cart. After the medication is made available, thenurse may scan the barcode labels to obtain information about themedication dosage, time for medication, frequency of the medication andthe like. The nurse may compare the image of the patient in the systemwith the image obtained from the bar code data. This comparison mayconfirm the patient for which the medication has been received. Allthese activities performed by the nurse after obtaining the medicationmay get recorded in the e-MAR chart. The warnings or alerts that thenurse may receive upon scanning the barcode may also get recorded in thee-MAR chart. The alerts and warnings may be for a particular drugallergy or reactions and the like. The e-MAR chart may also include arecord of the medication administered by the nurse to the patient.Further, the e-MAR chart may include a record of the forms filled by thenurses while administering to the patient. In an embodiment of theinvention, the recorded data in the e-MAR chart may be used to populatethe patient's health records in the E-EHR facility 118. In anotherembodiment of the invention, the recorded data in the e-MAR chart may beused to populate the MDS.

In another embodiment of the invention, the HPDMA 100 may provide anElectronic Treatment Authorization Request (e-TAR) form. The e-TAR formmay allow authorization requests to be created and updated online.Enquires related to authorizations and responses for requests made mayalso be conducted online. These online activities may provide moreaccurate diagnosis code and may also provide accurate billing codes.Further in an embodiment of the invention, the data in the e-TAR formmay be pulled in to the prescription management facility 106. Thephysician or the health specialist may utilize the authorization detailsfilled for certain types of drugs and treatments while prescribing themedication and treatment for the patient. In another embodiment of theinvention, the details filled in the e-TAR form may be recorded as theEHR of the patient in E-EHR facility 118. In yet another embodiment ofthe invention, the details filled in the e-TAR form may be utilized topopulate the MDS.

In another embodiment of the invention TAR's are treatmentadministration records and are created by assimilating the data relativeto the treatment of the patient (which as described herein is collectedin various ways including automatically via various sources). Due to thesystem having the various facilities described herein, which are (inembodiments) in real-time communication with one another, typicalinformation collected about the treatment of a patient can becontinually updated into a TAR. In this manner, TAR's accessible throughthe system are always current and need not be assembled retroactively asis the case with most MARs and TARs currently.

Further in an embodiment of the invention, the HPDMA 100 may facilitateproviding charts for recording subsets of data, such as a vital signschart for depicting the vital signs of the patient duringadministration. The different vital signs of the patient may include,without limitations, body temperature, pulse rate (or heart rate), bloodpressure and respiratory rate. These vital signs associated with patientmay be measured by the health specialist using the technology enabledautomatic data collection devices described herein that mayautomatically collect and/or generate data suitable for displaying avital signs chart.

Further in an embodiment of the invention, the HPDMA 100 may facilitateproviding charts for recording specialized assessments through the useof the real-time data collection and transfer capabilities described inreference to FIG. 1 (e.g. laboratory and/or therapeutic services, andthe like).

Report generation, dashboard interfaces, and the like may provideessential means for accessing, managing, and using the information thatmay be collected throughout the electronic real time medical informationcollection and processing system depicted in FIG. 1. Report generationand dashboard capabilities may be provided by dashboard facility 150depicted in FIG. 1. As depicted in FIG. 1, the dashboard facility 150may be communicatively coupled in real time with any of the facilitiesshow including the group of facilities within the prescriptionadministration facilities 110, the prescription management facilities106, and any other facility depicted.

The real time reporting facilities may generate reports by obtainingdata from any of a plurality of data sources, such as the sourcesdepicted in FIG. 1. Dashboards as may be supported by the real timereporting facilities may also be used to display the obtained data in acoherent format that may allow viewing a wide variety of importantpatient related information, such as the identity of a patient, thepersonnel who cared for or who are responsible for a patient, medicalhistory and prognosis, medications prescribed, medications that neededto be returned or destroyed, costs associated with medications that werenot covered or only partially covered by a payer, costs associated withmedications for which the health care facility had to pay, and the like.The real time reporting facility may also provide up to the minute,time-based summary information regarding the above parameters and any ofthe associated parameters. Such information may be presented to amedical professional through a graphical user interface with text,graphics, charts, images, audio, and the like. In an embodiment, thegraphical user interface may be associated with a computing deviceincluding, a mobile device, a PDA, a laptop, a smartphone and the like,

In an embodiment of the invention, the real time reporting facility mayprovide a Long Term Care (LTC) administrator dashboard. The LTCadministrator dashboard may be utilized to manage and plan the recordsand medication of patients that require long term care. An LTCadministrator dashboard may include the facility configured to access adatabase having information from a plurality of reporting sources. In anexemplary case, the reporting sources may include the prescriptionmanagement facility 106, the medication billing and dispensing facility,the medication dispensing machine, the medication administrationfacility, and an electronic health records facility. The LTCadministrator dashboard may also include a user selectable dashboarddefiner configured to provide user selectable options for defining theinformation from the facility to be presented in a report at thedashboard. The LTC administrator dashboard may further include a displaydefiner configured to operate in conjunction with the user selectabledashboard definer to define the format in which the report from thefacility is to be presented at the dashboard.

The LTC administrator dashboard may include a facility to provide thetype and cost of drugs consumed by the patient in a particular timeperiod. Variable time periods may be provided by the LTC administratordashboard and for each selected time period the dashboard may providethe type and cost of the drugs. This facility may further provide thecost of drugs consumed by each patient in a particular selected timeperiod. In an exemplary case, the LTC administrator dashboard mayprovide an interface for selecting a particular time period and a searchengine for selecting a particular patient.

The LTC administrator dashboard may further provide a field forobtaining insurance or Medicare costs. Many insurance plans and Medicaredo not pay for custodial care in which the patient receives assistancewith activities of daily living. These activities may include dressing,bathing, using the bathroom and mobility. Thus the LTC administratordashboard may provide information regarding the expenses that arecovered by the insurance plans and also those expenses which are notcovered by the insurance plans or Medicare.

Further, the LTC administrator dashboard may provide an interface forresolving issues related to reimbursements. This interface may optimizeand increase the reimbursement for the care provided, and reduce thenon-reimbursed items for the patient and the facility. In an exemplarycase, the dashboard may keep track of reimbursements for Part A servicesand Part B services for Medicare as well as services that have not beenreimbursed.

The LTC administrator dashboard may also provide an interface to obtainand update the status of bed occupancy. The interface may provideoptions to select a bed and a room for the LTC patient. This may alsosupport editing the patient's room information, putting a bed on holdstatus for the patient, maintaining the process of room/bed numbers aswell as assigning the wing/unit to those rooms/beds. Further, LTCadministrator dashboard may provide recalculations for differences incost of beds when a patient has been moved from one bed to another inthe same facility. Recalculations may also be needed when the bed isused in different shifts by the same or different patients; e.g. apatient may need the bed in the morning for dialysis and in the eveningfor another related treatment.

The LTC administrator dashboard may provide a field for maintaining drugutilization records. For instance, the LTC administrator dashboard mayrecord the specific drug used by the patient in a particular medicalcondition, along with details of dosage, time period during which drugwas administered, reactions or side effects of the said drug, resultingchange in medication, improved or deteriorated condition of patientafter using that specific drug, and the like. Further, the dashboard mayprovide such an interface for each patient in the facility.

In another embodiment of the invention, the real time reporting facilitymay provide an LTC facility specific dashboard. The LTC facilityspecific dashboard may be utilized for specific treatments andfacilities that may be provided to the patients in long term care. TheLTC facility specific dashboard may include an interface for obtainingElectronic-Medication Administration Record (e-MAR, embodiments of whichhave been described above) corresponding to a patient. The interface mayprovide the report that may serve as a legal record of the drugsadministered to the patient at a particular facility by the nurse or anyother healthcare professional. The nurse or healthcare professional maysign on the e-MAR at the time that the drug or device is administered.An e-TAR report may also document that the treatment that has beenprovided to the patient.

The LTC facility specific dashboard may also provide a field formaintaining billing and claim records. This field may calculate andprovide bills corresponding to each patient for a desired time period.The field may also provide preview of the monthly bills for a particularpatient.

The LTC facility specific dashboard may further provide a field forproviding the EHR, MAR, or any other data collected or stored by thefacilities described herein corresponding to individual patients orgroup of patients. Data may include a range of data in comprehensive orsummary form, including demographics, medical history, medication andallergies, immunization status, laboratory test results, radiologyimages, and billing information.

The LTC facility specific dashboard may also include an electronic orderfacility. The electronic order facility may include an interface foraiding an individual to a health care facility to enter electronicmedication, treatment and other orders. The system in certain conditionsmay require additional identification methods to uniquely identify,record, and document the care giver entering the orders.

The LTC facility specific dashboard may further include a facility fortracking the care plan and clinical outcome of the patient. With thisfacility, the user may be able to track the current care plan of thepatient in run time. The facility may also allow the user to track theclinical outcome of the patient. This facility may provide the updatedinformation of the care plan and the clinical outcome.

Further, the LTC facility specific dashboard may also provide a field tointerchange the therapeutic data related to a patient or a group ofpatients. This field may identify the most cost effective drug for abased on the margin for a facility availed by the patient. The field mayalso suggest a preferred list of drugs for a particular medication forthe patient. This preference may depend on several factors includingavailability of the drugs, cost and the like. Further in cases ofemergencies, the field may also suggest or change a particularmedication with blanket approvals. This may be useful as it may reducecycle time for taking approvals from individual doctors, otherphysicians and pharmacists.

The LTC facility specific dashboard may further provide a field forchoosing the non-formulary drugs. The field may further help the user tonote a drug if the ordered medication is on the formulary.

This dashboard may display data (which is collected in real-time andwhich is continuously updated) about the medications that are beingprescribed and administered to each patient as well as any other datacollected by the system. It can be broken down by facility, floor, wing,groups of facilities, etc. It can be broken down by patient. The LTCadministrator can also view a dashboard of the costs of the medicationsthat a patient is taking, the amount of reimbursement the LTC willreceive for the meds, the payment history of the patient, and the like.The dashboard provides the LTC administrator with the ability to canexaminer such things as: the most costly med, the most costly patient(in terms of meds administered and prescribed), what nurse administersthe most medications. Any information collected by the system can beselected and group according to user preference and/or preselectedparameters of patient, facility, floor, wing, groups of facilities,attendant staff, dose, cost, reimbursed amount from patient, insuranceor any government program. This information may assist the LTC admin inmaking operational decision regarding such things as therapeuticequivalents, staff, and other facility needs.

In an embodiment of the invention, the real time reporting facility maybe useful for monitoring automated real time surveillance or publicsafety monitoring. In an example, a dashboard may be useful formonitoring surveillance activities related to bioterrorism or epidemics.For instance, when the number of patients suffering from a particulardisease significantly exceeds a normal occurrence number, a monitoringdashboard may be updated by the real time surveillance facility todisplay a potential indication of an outbreak of an epidemic. Thisinformation could prove to be invaluable in implementing preventivemeasures in a timely manner.

Further in an embodiment of an invention, the real time reportingfacility may provide dashboards for a wide variety of uses and needs fordifferent users to generate different kinds of reports and managevarious facilities. In an exemplary case, the dashboards available mayinclude a specialist dashboard, a clinical outcome dashboard, a LongTerm Health Care (LTC) administrator dashboard, a LTC facility specificdashboard, a pharmacist dashboard, various planning dashboards,prescription management dashboards, and the like. Each differentdashboard may have different looks that may be represented by data entryor display fields or tabs. The dashboards may be populated in real timewith the data from any of the facilities depicted in FIG. 1 includingthe E-EHR/E-EMR facility 118 that may also be updated in real time withpatient healthcare related event data from any of the electronic realtime data collection facilities depicted in FIG. 1. In an example, thepatient healthcare related event data may include administration events,treatment outcomes and patient touch points. Further, the dashboards mayinclude tracking facility (not shown in figure) that may track andorganize the information on the care and cost being spent on thepatients and correlate it to previous/subsequent medical treatments.

Dashboards for specialists who are monitoring a patient such as aneurological physician, an endocrinologist, a cardiologist and a generalphysician may facilitate the collection and analysis of various tests,procedures, observations, and the like that may be conducted by orordered by a specialist. Inputs from each of these representativespecialists may be collated in a single report that each specialist mayview through a specialist dashboard. By being able to view real timeinformation about the patient, events, outcomes, tests, and the like, amedical specialist may provide inputs for further medication of thepatient (e.g. remotely).

Further, dashboards may be utilized to manage care planning. Careplanning dashboards may include a facility configured to access adatabase having information from a plurality of reporting sources, suchas those sources depicted in FIG. 1 including, without limitation theprescription management facility 106, the medication administrationfacility 110, patient attributes and outcomes 112, an EnhancedElectronic Health Records (E-EHR) facility 118, and other medicalinformation and patient care facilities. A care planning dashboard mayalso facilitate preparing different care plans for different patients.The care plans for any patient may be based on the needs of the patientsthat may be ascertained from profile information or medical history. Forexample, an over-weight patient may be offered a weight reduction careplan. Similarly, a person with high systolic blood pressure may beoffered a care plan that emphasizes exercise and restricted food regimefor controlling the blood pressure, and the like.

Dashboards may also be found in association with a clinical outcomefacility that may record anecdotal and empirical data related to thepatient care. A clinical outcome dashboard may further include a userselectable dashboard definer configured to provide user selectableoptions for defining the information associated with the clinicaloutcome facility to be presented in a report such as on a display of thedashboard. The dashboard may also include a display definer configuredto operate in conjunction with the user selectable dashboard definer todefine the format in which the report from the clinical outcome facilityis to be presented at the dashboard.

The clinical outcomes dashboard may allow managing outcome data such asthe patient's information from various sources and may include adiagnosis details, a history of the patient and related past clinicaloutcomes. Any information in the clinical outcome facility that may bemanaged by the clinical outcome dashboard may have been collectedautomatically, such as by using multiple sensors at a variety of patientmedical information touch points including the prescription managementfacility 106 (e.g. the dispensing and marking facility), theprescription administration facility 110, the outcome events facility114, an external data source not shown in FIG. 1, and the like.

The clinical outcome dashboard may further provide fields to group thepatients. The patients may be grouped on the basis of their prognosis,medication, treatment, attending support staff, doctor in charge,location of the patient, facility personnel associated/responsible withthe patient, and the like.

The clinical outcome dashboard may allow the user to input test resultsof the clinical outcomes for different patients. In an exemplary case,the dashboard may provide a menu of the different tests that may beprescribed based on the diagnostic outcome. The different tests mayinclude lipid profile, glucose test, blood test, sodium test, potassiumtest, liver function test or some other type of medical tests. Thedashboard may further update these test results in real time.

The clinical outcome dashboard may further provide an interface toobtain data from the prescription administration facility 110. This datamay include information about the type of medication given to thepatient, the time of administration, the amount of dosage, reactions andthe like. Data at the medication administration facility may be updatedin the real time and thereafter the updated data may reflect on thedashboard.

The clinical outcome dashboard may further describe different types oftherapies that may be relevant to the patients' condition. The differenttherapies may include Chemotherapy, Physiotherapy, SurgicalIntervention, Post-operative therapy, Integrative Therapy, CognitiveBehavioral Therapy, Psychodynamic, Developmental Therapy, and the like.

Based on the outcomes of the clinical tests, the clinical outcomedashboard may provide or suggest new therapies or drugs for thepatients. In an example, if a patient is a diabetic and after theclinical outcome it is identified that the patient also has heartproblems, then the dashboard may suggest a different drug for thepatient. Similar logic may be applied by the dashboard with regard totherapies. In an embodiment of the invention, the dashboard may apply aclinical algorithm tool to suggest new therapies and drugs. Forinstance, a patient with a history of high blood pressure and newlydiagnosed with high diabetes may not be prescribed the same medicationas another patient who only suffers from borderline diabetes.

The clinical outcome dashboard may further provide interface to changethe medication dosage of the patient. The change in dosage could occuras an outcome of clinical trials on the patient. This change will becommunicated in the network and accordingly instructions will be sent tothe pharmacy. For instance, a high blood pressure patient being treatedwith a specific drug may require a change after it is found that he hasdeveloped a persistent cough on account of that drug.

Further, the clinical outcome dashboard may allow the user to segmentthe outcomes according to different fields. These fields may be age ofthe patient, type of disease among patients, the medication given to thepatients and the like.

In yet another embodiment of the invention, the real time reportingfacility may provide a pharmacist dashboard. The pharmacist dashboardmay provide different fields to a pharmacist while the medication isbeing verified and is being dispensed from the pharmacy. The pharmacistdashboard may provide a field for viewing the placed electronic orders.

The pharmacist dashboard may further provide a field to track the datacorresponding to patient. This data may be utilized while verifying oraltering the medications for patients.

The pharmacist dashboard may also provide a field to receive and trackthe therapeutic interchanges for a patient for which the blanketapprovals have been provided.

The pharmacist dashboard may further provide tools and analytics to apharmacist to provide a better medication to the patient. These toolsmay suggest drugs and therapies to the pharmacist for the patient. Thetools and analytics may apply some algorithms and utilize past data,past history of the patient, clinical outcomes, and the like to providethese suggestions to the pharmacist.

In accordance with an embodiment of the present invention, physicianordering facility may be provided for administering and managingphysician's prescribing practices for a variety of functions, andspecifically for a patient care function.

The physician ordering facility may utilize significant data about thepatient care from the history or previous records. The data may includeprescribing practices administered for predicting or diagnosing aspecific user in real time. The patient care records may include varietyof information fields such as demographics, medical history, medicationand allergies, immunization status, laboratory test results, radiologyimages, billing information, and the like.

Information from the Electronic Health/Medical Record (EHR/EMR) may beutilized either standalone or in combination with other data by thephysician ordering facility. For example, a user in case of emergencymay be admitted in a hospital in Chicago, while on a business trip. Theidentification number of user may be used to access information from theEHR regarding the existing health conditions, past prescriptions, andany special needs may be accessed from his home town (for example,Kansas City). This may facilitate immediate and effective medicalresponse for the user.

In an embodiment, the data from the EHR may be combined with theaggregated data from third parties such as FDA regulation data. Thecombined data may be further processed along with real time pharmacydata (for example, from the closest neighborhood pharmacy or drug store)to obtain relevant prescription information for the patient.

In accordance with an embodiment of the present invention, theinformation from the ERR/EMIR may be used to populate the various fieldsof dashboards and similar other graphical interfaces. Examples of suchdashboards may include clinical outcomes dashboard, long term careadministrator dashboard, long term care facility specific dashboard,pharmacist dashboard, physician ordering facility dashboard, and thelike. These dashboards have been explained in conjunction with variousexamples earlier in the description.

For creating fields corresponding to clinical outcomes dashboard,information or documentation such as physician, nurse, and otherclinician notes, flow sheets, pre-operative notes, transcriptions,medical records abstracts, advanced directives, living wills, proceduralconsents, medical chat records, physiological monitoring outcomes, andthe like from the EHR may be utilized.

In accordance with other embodiments of the present invention,administration, nursing, laboratory, clinical, and radiology etc. Datamay be used in combination with the pharmacy data to generate fields,tabs, menu, or interface for dashboards.

In embodiments, the data may be a combination of system data, systemmetadata, system patient information, contextual data or some other typeof data.

The administrative data may include information related toregistrations, admissions, discharge, transfer (RADT) data. The EHR mayinclude levels of information regarding patient (e.g., name,demographics, next of kin, employer information, chief complaint,patient disposition.)

The laboratory data may include orders, results from laboratoryinstruments, schedules, billing, and other administrative information.Similarly, radiology data may include patient radiology data (e.g.,orders, interpretations, patient identification information), and imagesinformation.

Information for dashboard fields may also be obtained from traditionalpatient records such as progress notes, reports, medications, and ordersof diagnostic patient data such as medical images, electrocardiograms,scanned documents, and the like. In embodiments, information fromtraditional medical records may be directly utilized for generating thefield codes for various dashboards.

In other embodiments, information from traditional records may be firstrecorded in electronic form such as in ERR/EMIR and may be subsequentlyutilized by the dashboards.

For example, physician's scribbling and notes (e.g., response of apatient with a disjointed shoulder pain) in a hospital facility during avisit may be entered manually into an electronic database (e.g.,spreadsheet). This information may be used to generate or populate afield code ‘motor nerve response’ in the dashboard in the drill-downview.

In accordance with an embodiment of the present invention, the contentmay be uploaded in the EMR/EHR in real time from various sources.Examples of sources may include patient's attribute events,prescriptions, care planning, long term, laboratory data, and the like.

In accordance with an embodiment, ERR/EMIR data may be utilized foradministrating care planning facility. In addition, this data may beutilized to create an interface for care planning and management byhealthcare professionals and staff

Data from electronic records that may be utilized for care planning andadministration may include information on office visits, emergencyrooms, hospital-in patients, hospital out-patients, rehabilitation, longterm care facilities for care planning and nursing, and the like.

For example, information collected from EHRs of a number of patients mayindicate a growth in number of caretakers who stay with the patients. Inlight of this information, the administrative dashboards may be designedto include field codes related to preferences for caretakers of patients(e.g., meal choices, special needs).

Similarly, the information from EHR regarding special needs of a patientunder long term care and observations may be updated and made availablein real time to the nursing staff.

Care plan for an emergency room may be intensive and focused.Multidisciplinary team of experts may be deployed in the ER areas tomeet the variety of situations. In addition, individualized care plansmay be developed for an emergency department.

Similarly, care plan for a rehabilitation center may focus on a numberof parameters such as background needs of the patient, medical equipmentneeds, home healthcare environment needs, nutrition, supply,commodities, education & training, and the like.

Also, the needs of inpatients and outpatients may be different,emphasizing the need for different care plans for both of them.Inpatients may require nutritional and daily care (temporary) supportsuch as bathing or dressing while outpatients may prefer a short queuingtime for medications and check-up.

Maternity wards may also require a well designed care planning; forexample, requirement for a hygienic and separate ward for newborns andthose with special needs.

All the needs described above may be carefully administered by utilizingthe data from the electronic records, existing medical and hospitalrecords.

In accordance with an embodiment of the present invention, informationfrom electronic health/medical records may also be used for facilityplanning and operations.

Information from electronic health/medical records may be related to themix ratio of inpatient and outpatient services, older and criticallysick patient population, treatment patterns, advancement in technology,health data related to diseases and conditions (asthma, cholesterol,diabetes, heart disease, hypertension, obesity, and the like), type ofhealthcare (ambulatory services, ER visits, and the like), data relatedto injuries (accidents, suicides, homicides, and the like), life stagesand population (births, deaths, women's health, children's health, stateand territorial distribution, and the like.), lifestyle (drug use,smoking, exercise, and the like).

In embodiments, the in-patient data from EHR may include the number ofpatients under ‘critical conditions.’ In such cases, the facilityplanning in terms of resource allocation, forecasting, scheduling, andthe like may be performed effectively.

Similarly, non-patient aggregated EHR content such as for peopleaccompanying the patients may be used to design the facility operations.For example, a number of wait-in chairs, automatic dispensers for basicutilities, coffee vending machines, and the like may be installed in agiven facility to cater to the needs of the caretakers.

EHR/EMR data may also be helpful in planning facility operations withregard to medication supply management. For example, data fromaggregated health records may be collected and analyzed periodically toassess information fields corresponding to medications. In case therecords indicate high consumption patterns for Zyprexa for schizophrenicsymptoms, the medication supply management system may collaborate withthe pharma planning facility to identify drugs that may be lessexpensive and may be used as a substitute for Zyprexa.

Similarly, in case the records indicate that drugs containing ibuprofencomposition do not show high efficacy in a particular group ofindividuals, substitutes such as herbal substitutes or any other drugcomposition may be introduced in the medications supply.

Facility design may facilitate smooth flow of medication supply chain. Aseparate section or layout may be designed for provision of medicinesand other health related equipments and aids such as belts, bandages,syringes, and the like.

In accordance with an embodiment of the present invention, thesemedicine counters may also be self-help desk counters or online kiosks.Provision of such medication centers may facilitate smooth workflow forpatients, administrators, guardians, etc.; they may be effective due toreduction in time between diagnosis and administration of medicines, andmay be cost effective. In addition, it may also reduce the problemsassociated with non-availability of certain medications outside thehospital premises.

In another embodiment of the present invention, enhanced electronichealth and medical records data may be utilized to plan new services forthe healthcare facility. The aggregated data collected from E-EHRs mayindicate that healthcare services may need to be revamped and redesignedin order to facilitate growth. For example, performance indicators in arehabilitation center with regard to information dispersed on thehelpdesk may be collected and analyzed. In case the results obtainedfrom the collected data indicate that approximately 65 percent ofelderly people were not able to follow instructions provided at thehelpdesk, it may indicate a need for improvements in the services (suchas requirement of hearing aids and friendly visual signage on thehelpdesk.)

Similarly, data collected from E-EHRs may be used to plan for subscriberpreferences. For example, ‘energy drink preference’ field codes of anE-EHR may indicate that more number of individuals prefer ‘Drink X’ over‘Drink Y’ suggesting that more number of vending machines with ‘Drink X’may be installed. As an alternate example, two subscribers providingpackaging cartons for medical supplies may be compared on the basis ofthe EHR data such that subscriber ‘A’ (whose packaging is found to bewater proof has been consistently rated better by the healthcareprofessionals) may be chosen for a contractual agreement with thehealthcare facility.

In an embodiment, E-EHR data may also be used for planning insurancecoverage plans and insurance reimbursement processes.

For example, electronic records of a group of individuals from a familymay suggest a family based insurance plan; specific information may beprovided to these individuals regarding the various aspects of a familyinsurance plan.

In certain cases, a generic profile of patients and their caretakerssaved in the electronic medical records may be utilized for providinginsurance planning facilities. For example, insurance may be offered toan individual with a high risk job profile, suggested by the records forpeople visiting a healthcare center.

Further, E-EHR data regarding unused medications by any individual in agiven period may be used for insurance processing such aspayment/co-payment and reimbursement options.

In accordance with an embodiment of the present invention, electronicdata or health records may also be used for financial modeling andreporting to assess performance of one or more facilities.

With regard to financial modeling, variety of data both primary andsecondary information such as demographics, disease patterns and trends,market segments, demand and supply dynamics, competitive profiles,consumption patterns, and the like may be collected from the healthrecords, along with the information about the tangible and intangibleresources available with the healthcare facility. This information maybe further used to design appropriate financial models with regard tohealthcare business valuation, cost of capital, portfolio options, riskmodeling, option pricing, and the like for the healthcare and medicationmanagement facility.

In an embodiment, the estimated costs and financial forecasts may bepresented in the form of spreadsheets, reports, and other suchpresentation formats.

For example, financial modeling may be performed based on the datacollected from health records regarding the diminishing resources orobsolescence of a technology (e.g., health records indicating a numberof cases wherein a tumor was not detected in the early stages due toexisting technology limitations). This activity may be helpful injustifying a future course of action for a healthcare facility (e.g.,justifying new technology acquisition for ultrasound and imaging).

An enhanced electronic healthcare record (E-EHR) may be associated withthe facilities of the invention as depicted in FIG. 1 and elsewhere andmay exchange information (e.g. real time data) with the facilities. TheE-EHR/E-EMR facility 118 may maintain a collection of health records ofindividuals and/or groups in a digital format that is capable of beingshared across a medical facility or with external facilitieselectronically such as through Internet and the like. An E-EHR mayinclude any medical related data and information, such as a medicalhistory, allergies, pathology and laboratory test results, medicalscanning reports, region and residential information, and the like.

An enhanced E-EMR (E-EMR) may be generated in association with theE-EHR/E-EMR facility 118 and may be useful in an institution such as ahospital, clinic, physician's office, nursing home/center and the like.The E-EHR/E-EMR facility 118 facility may encompass information relatedto care across all settings and services such as administrative,nursing, lab, clinical, radiology, pharmacy, care planning, imaging,insurance planning, facility planning, rehabilitation, and the likewithout limitations. An electronic communication interface forimplementing retrieval of information by the E-EHR/E-EMR facility 118and push-out of information from the E-EHR/E-EMR facility 118 may beprovided thereby facilitating utilization of E-EHR related informationanywhere within an entire medical facility. For example, lab reports ofa patient stored in an E-EHR/E-EMR facility 118 may be utilized duringcare planning to prepare a healthcare plan for a patient. Similarly,data related to allergies and sensitivities for a patient may beutilized by a doctor to prescribe relevant medicine and offer treatmentaccordingly. The E-EHR/E-EMR facility 118 may interconnectelectronically with a variety of medical related facilities (e.g. thosewithin and without a central facility, those depicted in FIG. 1, and thelike) thereby forming a networked system where medical information of apatient or a group of patients flows in real time.

The E-EHR/E-EMR facility 118 may capture information from existingmedical records as well as third party data sources. The electronichealth facility may be connected with various other facilities for datacollection using sensing and monitoring devices. For example, updatesregarding relevant information from other facilities may be sensed bysensing and monitoring techniques and automatically delivered to beupdated with the E-EHR. In embodiments, delivery and receipt ofinformation may be facilitated through wireless methods ofcommunication. Similarly, any information from the E-EHR may also beretrieved by other facilities though wireless communication. In anembodiment, RSS data feed may be utilized to automatically retrieveinformation for an update with the E-EHR.

In accordance with an embodiment of the present invention, theE-EHR/E-EMR facility 118 may include an automated data discoverymechanism for tracking and collecting data from various facilitiesincluding those depicted in FIG. 1 and within a medical facility. Thedata discovery mechanism may collect prescription data, caregiver data,facility data, care plan data, patient identification details, outcomedata and the like. In an example, the E-EHR data discovery mechanism mayform an interface with the prescription management facility 106 todetect any updates, changes, details, and the like that are provided bythe prescription management facility 106 and the like. The discovereddata may be used by the E-EHR/E-EMR facility 118 to update an E-EHR orE-EMR which may be accessed on demand or automatically by otherfacilities.

The E-EHR/E-EMR facility 118 may also organize and manage themedical-related data and information in a systematic format (e.g.sequentially). The organization and management of data by theE-EHR/E-EMR facility 118 may be based determined needs for theinformation by the various facilities as depicted in FIG. 1. Forexample, separate databases may be maintained for information related todistinct facilities, such as care planning, diagnosis, labs and imaging,and the like. In another scenario, a data management process mayorganize E-EHR data based on demography, patients' index, and the like.In an embodiment, data organization and management may be performedthrough computer implemented methods. In accordance with this scenario,data may be gathered from various packages and processed by a processingmachine to map the data content into a single or multiple headers orcategories. The categories may be decided by an administrator.Accordingly, based on the segregation of data content into categories,an identifier may be associated with each data item and stored indatabases. The data content may further be manipulated through thisidentifier. Auto manipulation of data may also be performed byimplementing and running a set of rules.

The E-EHR data may be analyzed and used to develop statistical modelsfor health assessment of a group of people based on parameters such asage, geography, lifestyle and the like. The analysis and computationsmay be performed on overall data content. The E-EHR analysis andcomputation may be performed to address specific facility needs, such ascare planning, labs and imaging, prescription management, insurance andpayments and the like. Prescription management may benefit from E-EHRanalysis by receiving an analytical result that includes at least onepharmacy-related data element in context of one or more individuals'E-EHR data.

The E-EHR analysis and computations may be performed in real-time tofacilitate real-time solution exchange among the various facilitieswithin the medical profession, such as those depicted in FIG. 1. In anexample, data may be received by the E-EHR/E-EMR facility 118 for entryinto an individual's E-EHR. As that E-EHR record is being updated, thedata may also be analyzed to provide real-time feedback to aprescription management facility that is handling prescriptions for theindividual. This real time analysis and communication may be similarlyapplied to the other facilities depicted in FIG. 1 and elsewhere.

In accordance with various embodiments, data security may be ensured forthe E-EHR through authentication requirements. For example, a properauthentication of a user along with his personal as well as log indetails may be required during access and operation of the E-EHR. Inanother embodiment of a fully automated tracking and record keepingfacility, unique log in credentials may be provided to users who areregistered with the medical facility and corresponding details of usersmay be gathered and stored in a separate database. Any subsequentcorrespondence with regard to the E-EHR from a registered user may beaccompanied with certain security checks to confirm already storeddetails of the registered users. Further, various levels of accessassociated with the E-EHR may be encrypted for secured access by anauthorized and intended person only. Encryption may implement anauthorization protocol that may be decrypted by a specific secured keyonly. In an embodiment, a token may be issued to a user on any type ofassociation with the E-EHR that may enable further processing and assistin keeping track of user operations on the E-EHR. In an embodiment, thetoken may be generated using an automated system in the form of anauto-email.

In accordance with various embodiments of the present invention, systemdata may be registered at a central location. System data may includevarious software algorithms, operational and support data, content ofthe E-EHR, respective metadata, and definitions of metadata, attributesand characteristics associated with the data content, and the like. Thedata content may include semantics as well as representations. Further,the registered system data may be linked with various other data sourcesand interfaces through pointers. The central location associatingregistry of the system data may be protected with data security andencryption methods where only authenticated persons may find access.

In accordance with an embodiment, various business rules may beassociated with the E-EHR. These business rules may include detailsgoverning the flow of information from one facility to another. Forexample, delivery of drugs and medicines from the dispensing and markingfacility 104 may be terminated in case billing facility reportsinadequate advance payments. Business rules may be defined regardinginformation transfer from the E-EHR to the prescription managementfacility 106 or to a physician's prescribing device in case prescribedmedicines are found to differ from the prescribed guidelines on apatient's E-EHR.

The E-EHR may include and maintain a patient index that may include alist that refers to all patients registered with a medical facility. Thepatient index may be maintained on the basis of names, geography orlocation of patients, type of association such as temporary or permanentor with a specific facility such as cardiac or orthopedic, and the like.It may be appreciated by a person ordinarily skilled in the art thatE-EHR may be referred to by other names such as E-EMR and the likewithout limiting the spirit and scope of the present invention.

As explained earlier, data may be sourced from a variety of facilities,events, outcomes, actions, and the like to populate an E-EHR or E-EMR.Some sources of E-EHR data in a healthcare management facility may berelated to medication and staff administration, care and emergencyplanning, testing and validation, regulation, delivery, and the like.Data that may be sourced from events pertaining to the administration ofprescriptions may include date, time, location, dosage, prescriber,patient, medication, generic medication, type or mode of administration,undertakings, approvals, patient's mood and responsiveness (before andafter administration of medication), patient's reactions after takingmedication (comfort/discomfort), patient's pain perception, patient'ssymptom perception, response to side effects, other medicationsadministered during same time interval, patient's vital signs,presence/absence of other entities during administration, change inpatient's symptoms (e.g. improvement and/or worsening of the symptoms),and the like. In an example, in a hospital ward at least five out of tenpatients are given a dose of Drug X for treating a traumatic braininjury. The reaction of patients to the drug in the form of mood swings,behavior patterns, and responsiveness may be recorded in real time andsent to the outcomes analytics or databases. This information may befurther integrated with the E-EHRs of the individuals. These reactionsand patterns may be observed and recorded by the healthcareprofessionals such as staff, nurses, attendants, and the like and mayinfluence future course of action. These reactions and response patternsmay be automatically recorded, such as with sensors for measuringchanges in the blood pressure or nervous reactions of the patients maybe tracked. Emotions, moods, and patient response may be detected bygalvanic response sensors attached to the skin (sense arousal, fear,anxiety); heart rate sensors to sense agitation, stress, feeling ofcalm; Electromyogram (EMG) sensors implanted in muscle tissues tomeasure nervousness and relaxation; Electroencephalograph (EEG) scalpsensors for measuring brain activity; Magnetic Resonance Imagery (MRI),and the like.

Various data collection facilities may be provided for gatheringprescription administration data including mobile devices such as PDAs,smart phones, tablet PCs, notebooks, and the like. Other examples aredescribed above and elsewhere herein. These mobile devices may run onany operating system such as Windows Mobile, Windows XP, Palm, RIM andSymbian-based operating systems. These devices may be provided with dataencryption, medication verification software, scanning and trackingabilities, and user interface such as a graphical user interface. Inaddition, these mobile devices may be equipped with various applicationsto aid in the data collection, entry, and analysis process related to amedical condition of the patient. Of course, the mobile devices may beprovided with wired or wireless connectivity and may include scannersfor scanning barcodes on medications. Alternatively, the mobile deviceswith an in-built barcode scanner may be provided. The barcode scanningrecognition technology may capture medication data in real time andallow the staff or healthcare professionals to chart and maintain allcritical patient information as they administer the medications.Examples of barcode scanners may include handheld, pen-type, laser, CCD,camera-based, omni-directional, and some other type of scanners.Alternatively the scanner may be an RFID reader for reading RFID tags onmedications. The RFID data may be captured in real time and sent to theE-EMR facility for recording.

In another embodiment, data collection facilities and devices may beprovided with a web interface. The web interface may be accessed via anInternet, LAN, WAN, MAN, or some other type of network. The webinterface may be in the form of a dashboard. The web interface mayaccept an input (command, request, information, and the like) bygenerating web pages accessible via a web browser. The web interface maybe provided with security protocols for preventing unauthorized access.Alternately, data collection may be performed using a web applicationthat may run on a SaaS-based architecture. The access credentials suchas login information may be shared with the users (nurses, staff,administrators, and the like.) for downloading and accessing theapplication over the Internet. Upon accessing the application, a userinterface/dashboard/panel with a variety of select options in the formof tabs, menus, dropdown lists, and the like may be provided to theuser. Following this, the user may enter the medication administrationevent data for one or more patients.

In accordance with an embodiment of the present invention, datacollection may be facilitated via automatically generated signals fromtangible products such as medication supplies (medicines, bandages,packets, and the like), nutritional food packages, and the like. Inembodiments, the medication supplies and packages may be equipped withsensors, RFID sensors, tracking equipments, and the like for detectingsignals. For example, opening a glucose bottle may send this informationto a data collection facility for further processing. The informationmay include packaging date, manufacturing or batch number,manufacturer's name and code, retail price, and other similar details tothe data collection facility. Similarly, opening a packet of syringes orband-aids may signal the event information to the data collectionfacility. In embodiments, this information in combination with thelocation or spatial information such as GPRS information may be used fortracking complete real time event information.

Data may also be collected based on the observation recorded via a webor vigilance camera. The camera may be a mobile camera.

Data pertaining to events may be recorded, such as a conversationbetween a healthcare professional and a patient. With proper technologyenabled devices, voice records may also be converted into digital/EHRs.

Further, data may be collected from existing patient records. In anembodiment, data from manual, hard copy records may be transcribed. Incertain cases, event dating may be provided to the transcribed data forthe purpose of records.

In accordance with another embodiment, data from E-EHR/E-EMR facility118 may be accessed by other facilities such as care planning,rehabilitation, long term care facility, and the like, through an E-EHRSaaS service.

Data in an E-EHR may also be managed manually, such as through a userinterface. E-EHR patient management user interfaces may be provided withvarious functional fields to add a patient, discharge a patient, andedit patient's (demographics, room number, allergy, diagnosis, and thelike) information. In an example, a change in the room numberinformation for a patient may be sent in real time and updated in thepatient's E-EHR.

Various facilities may interact with each other such that the real timedata flows among them. For example, data from the administrative touchpoints (such as from a hospital ward) may be collected and shared withthe other facilities such as care planning, billing, E-EMRs and thelike.

The flow of data may be bi-directional between the facilities, i.e., thedata flow may be backward compatible. For example, data sent from thepatient's care department to the orthopedic department may reflectmultiple incidences of fractures; this information may indicateosteoporosis and a bone density test may be advised by the orthopedicdepartment along with a blood test to the care department withinstructions indicating fragility of patient's bones and advocating duecare.

E-EHR may include data that may be related to financial transactionssuch as billing, payment, insurance, and the like. For example, apatient may be undergoing a test in a laboratory. Real time informationabout the nature of test may be broadcasted to the billing facilitywhere an automatic receipt may be generated indicating the amount to bepaid by the patient based on the insurance coverage availed by him (theinsurance information may be obtained in real time from the insurancefacility).

Similarly, real time data from patient touch points such as patientattributes/events facility may be utilized for various insuranceprocessing activities such as determining submittal process and norms,eligibility benefits, coverage response, and the like. Specifically forcoverage response, real time data from patient touch points may be usedto ascertain events such as if a given treatment/medicine is coveredunder an exceptional case, or if it requires certain prerequisite eventsor conditions.

Likewise for payment options, real time patient E-EHR data may be usedfor establishing conditions or procedures for co-payment andreimbursement for unused medications.

E-EHR data collection may be related to new prescription events. In anembodiment, data tracked in an E-EHR for a new prescription by a doctormay include various aspects of the medications such as brands,allowability for substituting generics, dosage frequency/quantity,administration schedule and/or requirements, durable goods,rehabilitation requirements (treatment/therapy), and the like.

Data that may be stored with an E-EHR/E-EMR facility 118 (e.g. in anE-EHR) may also be collected from electronic orange book (maintained byUnited States Food and Drug Administration) regarding new information onapproved drug products, generics, proprietary name info,applicants/owners, legal protection, and therapeutic equivalents. Thisinformation when made available in a patient E-EHR may be updated inreal time and the updated information may be reflected in the markingson packaging of medications; for example, information regarding the modeof consumption, sun exposure, and the like may be printed on the labelof a medication bottle.

Data pertaining to new events may be shared with the pharmacies andtreatment and care centers such as long term care and rehabilitationcenters. In addition, the collected data may be used to managedispensing/supply chain operations at the pharmacy. For example, a realtime data collected for increased number of cases for stomach flu mayhelp the pharmacy schedule its delivery side operations proactively.Similarly, data pertaining to transactions for purchasing medications atthe pharmacy windows may also be tracked.

Pharmacy-related data tracking may include home delivery orders for amail order pharmacy may be tracked and recorded in the E-EHR in realtime (e.g. shipment from the pharmacy, in-route tracking, delivery, andthe like)

The E-EHR may also receive data pertaining to patient-specific clinicaloutcomes from various sources such as laboratories, imaging facility,regulatory facilities, third parties, and the like. Outcome data may beprovided electronically from computerized systems associated with thefacilities or with an individual patient (e.g. web-based data entry by apatient). Clinical outcome data may include real time data collectedfrom laboratory and imaging services such as tests requested, intakenotes, medical samples, electronic measurements, clinician readings ofresults and notes, primary or specialists care reading and notes, andthe like.

Patient touch points may include the facilities and facility in thehealthcare management platform where real time event tracking concerningvarious aspects of medical care may be conducted. Personal records anddocumentation from these touch points may include information such ascapacity planning (number and details regarding people working in thefacility), time-in and time-out management for employees and staff, andsome other types of information

Clinical outcomes may be a form of patient touch point, but other datafrom other patient touch points may also be captured by the E-EHR/E-EMRfacility 118. Patient interviews, a common healthcare practice, mayinclude data that can be captured (e.g. in real time) and delivered tothe E-EHR (or to other facilities as described herein). For example,conversations between a patient and a rehabilitation specialist may becaptured in the E-EHR (in the form of handwritten notes, short-handwritings, graphical symbols, voice recordings, and the like). Likewise,statistical information (e.g. vital signs) such as body temperature,pulse rate, blood pressure, respiratory rate, and the like may also becollected in real time from patient touch points. Collection of vitalsigns information may be a pre or post prescription administrationactivity.

Real time data collection from patient touch points may be used forimproved pharmacy management in other ways including patient-specificmedication review when a prescription is received in the prescriptionmanagement facility 106. As an example, a patient's E-EHR may indicatethat the patient is being administered a daily dose of ranitidine fortreatment of a peptic ulcer. The pharmacy management facility mayreceive a new prescription for the patient for ‘nizatidine’. The newprescription information may trigger the pharmacy management facility toretrieve the pertinent portion of the patient's E-EHR to performvalidation, generic selection, and the like based on this informationalong with the patient's condition(s), aptness, and potential sideeffects of these medicines. The result may determine the course ofprescription for the patient. Further, real time patient response fordifferent treatments and/or medications may be stored as an E-EMR recordand may be used to provide feedback for pharmacy development. Forexample, a response from a number of patients regarding taste of amedicine may be provided as a feedback to the concerned drugmanufacturer.

E-EHRs may be maintained for easy, authentic and reliable access. In anembodiment, the movement, adequate storage requirements, and storagelocation of health records (e.g. in an E-EHR or E-EMR) may be controlledto ensure that records may be accessed in real time and at any giventime. E-EHR maintenance may include a records recovery solution. OtherE-EHR maintenance activities may support audit trail periodicevaluation. Further, various control measures such as access monitoring,user verification, authorized destruction and security controls may beintroduced to prevent unauthorized access, destruction, alteration orremoval or records, and the like.

Because individual facilities may choose to maintain portions of patientrecords locally (or at least maintain certain information separatelyfrom a comprehensive E-EHR) the E-EHR/E-EMR facility 118 may facilitateensuring data integrity across all the records at all the locations. Forexample, if a person changes his/her contact address in the records ofthe care planning facility, it may be validated through the E-EHR/E-EMRfacility 118 to ensure that the information is accurate. Therepresentative at the care planning facility receiving the new contactaddress information may confirm with the patient that this informationshould be applied to all of the patient's medical records beforesignaling to the E-EHR to apply the change to the E-EHR database.

Data from E-EMR/EHR may also be combined with other non-E-EHR data suchas clinical studies, drug interactions and company data, and the like tofacilitate a well informed decision process making by the concernedhealthcare professionals and/or entities. For example, allergyinformation for a patient profile may be combined with the real timepharmacy information on substitutes to validate the prescribedmedications for the patient.

When combined with other data, E-EHR data may be used in a variety ofways including creating prescription guidelines for physicians and theattendants, determining the potential outcomes of a prescribedmedication/treatment administration. The potential outcomes may beuseful for avoiding adverse medication's reactions or interactions,customizing dose in accordance with patient perceptions, identifyingineffective medications for particular patients, identifying patientprofiles for high effectiveness of medications, treating co-morbidity,identifying unexpected benefits from unrelated conditions, linkingperceived/actual benefits of medications to other factors, and the like.For example, a pain perception with medication administration may bedependent on other factors such as alertness, physical activity,entertainment, mood, and the like.

Further, the E-EHR may include information about a patient's daily life(e.g. information on the nutrition, activity, exercise, sleep patterns,and the like) which may be used during any subsequent patient touchpoint. The E-EHR with this diversity of information, including real timeinformation as described herein may be useful for a more comprehensiveassessment of the patient, such as during an emergency by EMTs, theemergency room nurses, and other medical care professionals.

As discussed earlier, E-EHR/E-EMR data may also be useful for insuranceplanning. Real time information regarding thepurchase/modification/renewal of health policies for a patient may beupdated in the records. Based on the records of an individual regardinghis own and family's needs, an insurance plan may be offered to him.Alternatively, consolidation of E-EHR data from a plurality of patientswhile maintaining confidentially of the patients may benefit aninsurance planning activity that may relate to plans, coverage, rates,costs, payment processing, and the like.

Real time health care data from electronic records (e.g. EHR) may beadvantageous for management and operation of a long term care facility.Individual E-EHRs may be accessed to determine eligibility for treatmentin the facility, specialists and/or equipment that would be needed atthe facility to support the individual, and the like. Consolidated E-EHRdata may help with planning of facility expansion, professionalrecruiting, and the like.

In embodiments, real time data from enhanced E-EHRs may be utilitarianfor a physician or specialist with regard to prescribing treatment andcare. The dynamic, real time nature of the E-EHR/E-EMR facility 118 andcommunications depicted in FIG. 1 and described herein may benefit theuse of remote specialist evaluation in real time of a patient thatheretofore was unknown to the specialist by making the information inthe E-EHR current, relevant, and continuously updated through the realtime updating capabilities described herein. In another example, adoctor may be sensitized about the allergy conditions of a patientbefore prescribing medications to him/her.

The E-EHR/E-EMR facility 118 may facilitate integrating data receivedfrom various facilities including dispensing & marking facility, Rxdelivery, patient events, outcome events and the like. The data may bereceived by the E-EHR/E-EMR facility 118 through streaming data fromthese and other sources. This integration may result in further improvedenhanced electronic records for patients. In addition, such an enhancedrecord may create additional knowledge about the patient such astendencies for certain diseases that may be inherited.

In one embodiment, the enhancement may be in the form of integration ofthe patient's insurance history with the medical data. In anotherembodiment, the integration may be of data associated with clinicaltrials. In yet another embodiment, the data integration may be with apharma co-vigilance database, drug database, health database or someother type of health database. In yet another embodiment, E-EHR/E-EMRfacility 118 facilitated data integration may enhance E-EHR and E-EMRdatabases by integrating them with electronic patient check-ins, accessto patient records either at day or at night, instant messaging,transcription facility, payment information, scheduling of health care,electronic medical billing, claim management facility, reimbursementfacility, alert facility, order tracking, archiving, reporting, andinterfacing with tablet PC, PDA, Fax, scanner and the like.

The E-EHR may be in a digital format that may include data incomprehensive or summary form, such as medical history, laboratory testresults, billing information, and the like.

As described herein and elsewhere the E-EHR/E-EMR facility 118 may be anapplication that may be implemented in distributed data storage systemsthat may be located at different locations so that an enhanced E-EHR fora particular patient may be fragmented at various locations based on aparticular attribute of the patient data. The attributes may beassociated with patient history, patient diagnosis, patient treatmentand the like. In an embodiment, distributed nodes of such a database maybe interconnected through a communication channel.

In accordance with various embodiments of the present invention, theenhanced E-EHR may include a data integration facility with featuresdescribed herein above as well as providing users with a unified view ofthe data. For example, the data integration facility may feed data inreal time from a variety of sources to a clinical repository that may beviewed by customers. Further, the data integration facility may enablehospitals, clinics, and the like, to share and analyze the data withother hospitals, regional health organizations, and the like. In onescenario, the data integration facility may replicate the data whileloading the data into the health records and other applications. Thedata integration facility may also store a backup of the data in asecond repository that may be used to feed the data back to the enhancedE-EHRs in real time, in case the original data is lost due to somereasons.

In another scenario, the E-EHR may include an Extraction TransformationLoad (ETL) facility. The ETL facility may be used in association withthe data integration facility that may enable extraction of data, suchas patient data from an outside source such as lab reports, consultationreports from different clinics, and the like. Extraction from theoutside source may involve converting the data into a format capable ofundergoing transformation processing. Thereafter, the data may betransformed to meet technical and business requirements of a targetdatabase. For instance, word-processing data might be translated intonumbers and letters, which are easier to track in a spreadsheet ordatabase program. Finally, data may be loaded into the target database.Some databases may overwrite existing data with cumulative effect, withfrequent updating of extract data being done on daily, weekly or monthlybasis. Further, some databases may update the data in real time.

In an embodiment, the E-EHR may also be provided with a StatisticalAnalysis System (SAS). The SAS may facilitate data entry, retrieval,management and mining of the data by the users. For example, a user mayenter information such as patient ID, name of a patient, and the like,for retrieving details such as billing information, medical history, andthe like, about the patient from an E-EHR. The retrieved data may bemanipulated by the user and may thereafter be extracted from the SAS.The SAS may also enable the user to analyze data on the basis of medicalhistory of the patient, such as for the purpose of evaluating progressin medical conditions of the patient, and the like. In another example,the user may be able to obtain a statistical analysis of previousreports of the patient that may be stored in an E-EHR. For example, if apatient with blood group O positive needs to be administered drug Y, theSAS may enable a user such as a doctor, a nurse, and the like, to run astatistical analysis for finding the effect of the drug Y on patientrecords with the same blood group. Such an analysis may enable the userto find out whether the patient with blood group O positive is allergicto drug Y or not. In case an allergy is discovered, the SAS may triggeran alarm to caution a physician regarding the allergy. The physician maythen replace the drug Y with another medicine that may not cause allergyin the patient. In an embodiment, the statistical analysis may be run onthe basis of age of the patient, medical history of the patient, and thelike.

In accordance with various embodiments of the present invention, theenhanced E-EHR may include Service Oriented Architecture (SOA) that mayhelp healthcare-related IT organizations to improve patient treatmentmethods and billing techniques. The SOA may enable IT organizations tofocus on improving the health information systems by removingsystem-to-system communication problems and by making healthcareorganizations more adaptable to change. In another embodiment, the SOAmay also establish architecture standards for data formats and systeminterfaces that may promote sharing of information. For example, insteadof mapping patient demographics from an E-EHR system and each clinicalsystem in a point-to-point fashion, the SOA may enable the E-EHRapplication to abstract the differences in the data and interfaces.Specifically, instead of having hundreds of point-to-point interfaces inthe E-EHR, there may be only one service interface for each functionthat may greatly reduce complexity and maintenance costs.

In an embodiment, the E-EHR application may enable the patient-relateddata such as medical history, medical bills, and the like, to betransmitted or received using data streams. In embodiments, the datastreams may be a communication medium that exchange data to and from thehealthcare platform. E-EHR may be capable of producing a data streamthat may be read by other health systems and other data managementsystems. Representing the patient data as a data stream may provideinteroperability between systems that may support continuous care ofpatients who move between health care systems and facilitate merging ofthe patient data from multiple sites of care for regional, national, andinternational monitoring. Hence, the E-EHR application may includefunctionalities for importing and exporting data between two health caresystems that may be accepted and transmitted in a standard format.

Various security measures may be taken into consideration whileaccessing an E-EHR. The security measures may be software based orhardware based. The patient data saved in the E-EHR may be secured byproviding access control, such as password protection and network-basedadmission control that limits access to authorized users and devicesonly. Further, the security devices associated with the network mayprovide protection for a wide range of mobile devices that includeservers, laptops, tablet PCs, and personal digital assistants (PDAs)from intrusions and outbreaks, such as worms, virus attacks, and thelike.

Further, various technologies may be used by the E-EHR application forcollecting the patient data for maintaining records. The records mayinclude details such as medical history of the patient, and the like.The records may be maintained by healthcare organizations as well as bythe patient. The E-EHR application may enable automatic collection ofexternal data such as billing information, details of medical history ofa patient, and the like. For example, scanned images, records, and thelike, may be directly fed into a computer system of a clinic, healthcare organization, and the like. Examples of the technologies mayinclude, without limitations, bar codes, radio frequency identification(RFID) technology and voice recognition. For example, bar codes may beused for capturing the external data; for instance, information of drugsbeing administered to a patient may be captured by a bar code readerdevice in real time. The captured data may be related to medicines beingadministered to patients. Similarly, the RFID technology may be used forthe external data related to medical assets. Further, RFID technologymay eliminate wastage of time that may be spent by doctors and nurses onsearching for supplies and equipment, thereby leaving more time for themto attend to patients. The RFID technology may allow improvement inquality, safety, efficiency and care coordination within a hospital, ahealthcare organization, and the like. Additionally, the RFID technologymay also be used in real-time location tracking systems.

In an embodiment, an E-EHR application may provide voice recognitiontechnology for collecting data related to a patient. The voicerecognition technology may convert spoken words into text in real time.The data collection process using voice recognition technology may bemore effective and may be performed more easily when deployed inconjunction with a voice recognition facility. For example, searches,queries, and form filling may be performed faster by voice recognitionthan by using a keyboard. Likewise, voice recognition technology mayenable physicians to produce records and reports for patients in realtime.

In accordance with various embodiments of the present invention, remotecollaboration tools such as web cams, chat/internet messenger (IM), andthe like, may associated with the E-EHR. For example, a web cam mayenable a user to take a snap shot of a patient's physical findings,especially for dermatological conditions. The captured image may then betagged to a medical record for monitoring progress and treatmentoutcomes of the patient.

In another embodiment, the E-EHR application may support access of thedata related to medical history of a patient, medical insurance, and thelike from a remote location by means of hand held devices such as mobilephones, PDAs, and the like. For example, physicians, clinicians, and thelike, may access patient data from any entity that is capable ofconnecting to the network, regardless of where the records wereoriginally stored or input. In such a scenario, the E-EHR applicationmay store copies of the records on a server that may be accessed via aweb browser. Accordingly, a user may easily access, modify or transferthe records of the patients to other hand held devices. In anotherexample, physicians may simply log into a remote system and may retrievethe record of a patient to initiate treatment.

In yet another embodiment, the E-EHR application may be capable ofproviding data in real time about patient care. For example, if apatient is undergoing treatment in a hospital, the E-EHR application mayenable the medical records of the patient to be updated in real time bya user such as a doctor, a nurse, and the like, based on diagnosis ofthe patient, medicines being administered currently to the patient,dosage of the medicines, and the like. In another example, real timeconnectivity between a pharmacy and a workstation of a doctor mayprovide information to the doctor about availability in the pharmacy ofvarious medicines to be administered to the patient. In a similarmanner, the E-EHR application may provide real time data about varioustreatments being conducted for a patient.

In accordance with various embodiments of the present invention, machinelearning (ML) techniques may allow the E-EHR application to facilitateand enhance work of medical experts, thereby improving the efficiencyand quality of medical care provided by medical experts. The ML methodsmay facilitate the E-EHR application to automatically recognize complexpatterns and make intelligent decisions such as analysis of patienttreatment data, and the like, based on data that may be alreadyavailable in the E-EHR Examples. Further, the ML methods may be used toanalyze clinical parameters and their combinations for prognosis, e.g.prediction of disease progression, for extraction of medical data, andthe like. The ML methods may also be used for data analysis, such asinterpretation of continuous data used in the Intensive Care Unit;intelligent alarming during situations that may require immediate actionthereby resulting in efficient monitoring, and the like.

In a scenario, the E-EHR application may also provide assistance, suchas vocal assistance, for enabling the user to operate the E-EHRapplication efficiently. For example, if the user encounters someproblem in accessing the record of a patient, the user may take the helpof the voice assistance service offered by the E-EHR application. In ascenario, the user wearing a headset device may be able to listen to thevoice-based assistance and act accordingly.

Furthermore, a user may scan images of an injury, and the like, capturedthrough handheld devices such as mobile phone camera, and the like. TheE-EHR application may enable the user to scan the images and save thescanned images, along with the records of a patient. In an embodiment,the user may scan old medical documents of the patient and may save themalong with new electronic data of the patient. In addition, the user mayalso index the scanned documents in the E-EHR based on date of birth,patient ID number, and the like.

In accordance with various embodiments of the present invention,artificial intelligence based delivery networks may help in automatingthe production of medical documentation. In an example, the deliverynetwork may optimize the storage of the medical record. In anotherexample, the delivery network may enhance the retrieval of the record.Such delivery networks may perform diagnosis and also makerecommendations for therapy. For example, a representative model maydepict the symptoms of stomach flu, along with typical clinicalmanifestations of stomach flu, such as diarrhea, high temperature,nausea and loss of appetite. Based on this symbolic model, an artificialintelligence delivery network may automatically diagnose the diseasebased on input of symptoms and provide advice on a course of treatmentto be followed.

In another embodiment, various identification technologies such as afacial recognition system, biometrics, and the like, may be utilized bythe E-EHR application for automatically identifying or verifying a user.For example, the E-EHR application may compare selected features of theperson with a facial database to allow access to the record of apatient. The identification technologies may be implemented owing to thepatient's right of privacy and to the need for security measuresmandatory in healthcare.

The E-EHR application may set up a virtual private network (VPN) thatmay be used by healthcare information systems of a hospital, ahealthcare organization, and the like. Healthcare organizations may facehurdles in making secure patient records and other sensitive healthinformation due to widespread internet usage. The VPN may allowpatients, doctors, medical organizations, insurance companies andgovernment agencies, alike to communicate effectively and economically.Further, the VPN may use passwords, biometrics, two-factorauthentication or other cryptographic methods for securing records ofthe patients. Additionally, the E-EHR application may provide securetunnels from workstations to order entry facility. For example, a usermay enter an order for medications from a workstation such as a careplanning facility. The order entered by the user may be viewed in realtime by a pharma planning facility. The pharma planning facility maysend the order to a prescription validation facility that may facilitatein dispensing the ordered medications to a patient upon validation ofthe order. The information transfer between two or more workstations asdescribed above may be done using the VPN.

Further in accordance with embodiments of the invention, the system mayinclude a voice activated care tracker facility. This facility may allowthe caregiver to track various activities through voice commands. In anexemplary embodiment, the system may store all the information relatingto the patient. The caregiver may interact with the system to providevarious facilities to the patient.

In an exemplary case, the tracker facility may track the charting tool.The charting tool may include an enhanced Medication AdministrationRecord (MAR) chart. The caregiver may activate the MAR chart with thehelp of voice commands.

The tracker facility may also monitor the Activities of Daily Living(ADL). The ADL may include the daily life activities like feeding,bathing, dressing, grooming and the like. The caregiver may interactwith the system to demand support staff for helping the patient withdaily activities. In an embodiment of the invention, data related to thefacilities provided for the daily activities may be utilized to populatethe MDS.

The voice activated care tracker facility may further be utilized totrack the medication to be dispensed to the patient. The system may havethe details of medication to be given to the patient. The caregiver mayconfirm these details with the system before providing the medication tothe patient.

The voice activated care tracker facility may further allow thecaregiver to connect to the administrative or billing facility forproviding billing information. There may be scenarios when a change inthe medication may be required and it may be reflected in the billingdetails of the patient. In such a case, the caregiver with the help ofvoice activated care tracker facility may connect to billing facility toupdate this information.

The voice activated care tracker facility may further allow thecaregiver to page other staff members or doctors for support in caringfor the patient. There may be cases when an elderly patient may requirea wheel chair for some kind of movement. The caregiver may send a pagingmessage to the desired staff member. The desired staff member mayreceive this message through the system and make the wheel chairavailable.

In an embodiment of the invention, the caregiver may interact with thevarious facilities using a pair of headphones. Further in anotherexemplary case, a voice activated care tracker facility of the presentinvention may be used with third party products such as ACCU-NURSE orCARE TRACKER.

Further in accordance with an embodiment of the invention, themedication administration data stored on the data server may be adaptedto populate a Minimum Data Set (MDS). The MDS may be a part of the U.S.federally mandated process for clinical assessment of all residents inMedicare or Medicaid certified nursing homes. This process provides acomprehensive assessment of each resident's functional capabilities andhelps nursing home staff identify health problems. The MDS may bepopulated in different ways. In an exemplary case, the MDS may bepopulated with data provided as per the standards of National Councilfor Prescription Drug Programs (NCPDP). NCPDP is any entity whoseprimary activities are developing, coordinating, promulgating, revising,amending, reissuing, interpreting, or otherwise maintaining standardsthat address the interests of a wide base of users outside the standardsdevelopment organization. The membership of NCPDP provides leadershipand healthcare business solutions through education and standardscreated using the consensus building process. NCPDP has been named inthe US federal legislation, along with the Health Insurance Portabilityand Accountability Act and the Medicare Prescription Drug, Improvementand Modernization Act.

In another exemplary scenario, the MDS may be populated by providingdata as per the standards of the Health Level Seven International (HL7)feed. The HL7 provides standards for interoperability that improve caredelivery, optimize workflow, reduce ambiguity and enhance knowledgetransfer among all stakeholders, including healthcare providers,government agencies, the vendor community, fellow SDOs and patients.

In yet another exemplary case, an Extensible Markup Language (XML) feedavailable as a web service may be captured by the MDS. The XML feed issyndication feed parser for both RSS and Atom feeds. It also implementsfeed auto-discovery for finding feeds, given a Uniform ResourceIdentifier (URI). The XML feed supports the following syndication feedformats: RSS 0.91, RSS 1.0, RSS 2.0 and Atom. The XML feed may provide aunified Application Programming Interface (API) for parsing and usingthe various syndication formats.

In yet another exemplary case, the MDS may be populated in the manner ofSoftware as a service (SaaS). SaaS is a model of software deploymentover the internet. With SaaS, a provider licenses an application tocustomers for use as a service on demand, either through a timesubscription or a “pay-as-you-go” model. In yet another exemplary case,the MDS may be populated through Cloud computing. Cloud computing isInternet-based computing, whereby shared resources, software andinformation are provided to computers and other devices on-demand, likea public utility.

In yet another exemplary case, the MDS may be populated through aService-Oriented Architecture (SOA). SOA is a flexible set of designprinciples used during the phases of systems development andintegration. A deployed SOA-based architecture will provide aloosely-integrated suite of services that can be used within multiplebusiness domains.

In yet another exemplary case, the MDS may be populated by storing datain a database using the Structured Query Language (SQL). The data mayfurther be populated using .NET framework.

In yet another exemplary case, the MDS may be populated using JavaServer Pages (JSP), Active Server Pages (ASP) or asynchronous JavaScriptand XML (Ajax) front end.

The healthcare and pharmacy data management and administration platformmay further be implemented in different environments. The differentenvironments may include a Long Term Care (LTC) facility, a SkilledNursing Facility (SNF), and the like. A LTC provides residential dailyliving and medical services to a patient requiring extended medicalattention. Such a facility may provide rehabilitative, restorative,and/or ongoing skilled nursing care to patients or residents in need ofassistance with activities of daily living. Long-term care facilitiesinclude nursing homes, rehabilitation facilities, inpatient behavioralhealth facilities, long-term chronic care hospitals, and the like. TheSNF is a place of residence for people who require constant nursing careand have significant deficiencies with activities of daily living. TheSNF may include rehabilitation and various medical and nursingprocedures. In SNF, every patient is under the direct supervision andcare of a physician, such that the physician may be available on anemergency basis. Further, the records of the condition and care of everypatient may be maintained, nursing service may be available with atleast one full-time registered nurse on duty 24 hours a day. Also, theSNF may have appropriate facilities for storing and dispensing drugs andbiologics.

The healthcare and pharmacy data management and administration platformmay also be implemented through an environment such as the AssistedLiving Facility (ALF). An ALF may provide supervision or assistance tothose living in a Residential Care Home, Assisted Care Living Facility,or a Personal Care Home; they do not need constant nursing care but needhelp with activities of daily living. Coordination of services byoutside health care providers and monitoring of patient activities toensure their health, safety, and well-being may also be provided.Assistance may further include the administration or supervision ofmedication, or personal care services provided by a trained staffperson.

Further, the healthcare and pharmacy data management and administrationplatform may also provide assistance to patients who choose anindependent living environment. In times of illness or disability due toadvanced age, when managing activities of daily living becomesdifficult, help may be provided in the form of limited time care by ahealthcare provider who visits at specific times to perform specificjobs such as administering medication, bathing, grooming, cooking,feeding, and the like.

The healthcare and pharmacy data management and administration platformmay further be applied to different environments of medication delivery.The healthcare platform may provide different tools to reduce thedelivery costs of the medication. In an exemplary case, the deliverycosts may be reduced by hedging the fuel or gas prices. Hedging willreduce or eliminate financial risk involved with variation in prices ofgas. The healthcare platform will take two positions in the equity orcommodity market that will offset each other if prices of gas change.

The healthcare and pharmacy data management and administration platformmay also reduce the delivery costs by cutting down some routes. This maybe achieved by identifying the routes at which less medication aredelivered and are also longer. Such routes may be cut down or thefrequency of delivering the medication may be reduced on these routes tosave the resources.

Further, the healthcare and pharmacy data management and administrationplatform may apply some algorithms to identify the proximity of thedelivery destinations. By identifying the proximal destinations, thehealthcare platform may be able to control the frequency of delivery ofmedication to these destinations or may group the medication for thedestinations that are close to each other.

The healthcare and pharmacy data management and administration platformmay also apply Artificial Intelligence (AI) based routing tools toidentify the most efficient routes. In an example, the healthcareplatform may use Dijkstra's algorithm to find the shortest route.

The healthcare and pharmacy data management and administration platformmay also reduce the cost of delivery in real time routing. Deliveriesmay be regular deliveries or may be sweep run that cover a range ofdelivery locations in a geographic region or locale.

The healthcare and pharmacy data management and administration platformmay assist in grouping the delivery orders. The grouping may be done onthe basis of the facilities provided to the patients. Patients availingthe same physical facility may be grouped together and medication forthe entire group may be delivered together. Orders may also be groupedon the basis of the wing occupied by the patients. Orders for patientsin the same wing may be grouped together. Order may also be grouped onthe basis of the time of administration of a group of patients. In anexample, if the administration time for a group of patients isoverlapping then the order for all those patients may be groupedtogether. Various other groupings are described herein and includegrouping by floor, wing, section, demographic, type of medication taken,facility, group of facilities, geographic region, by attendingphysician, by nursing staff, and the like. For medications that have tobe administered at various times throughout the day, all of a patient'sdaily medication may be grouped by administration time and delivered fora specific patient to a location from which a healthcare provider canpull the medication at the required time. For a group of patientsreceiving medications throughout the day, the medication may be groupedby time of administration for the group of patients and delivered to thecaregiver location for that group of patients (e.g. a wing of a patientfloor in a long term care facility).

The healthcare platform may further facilitate populating of E-EHR withthe clinical outcome data. Outcome data may include patient response tomedication, resolution or worsening of symptoms, onset of new symptoms,and the like. The outcome data may include pain, fatigue, physicalfunctioning, emotional distress, and social role participation that mayhave a major impact on quality-of-life across a variety of chronicdiseases.

The clinical outcome data may be obtained from various sources. In anexemplary case, the clinical outcome data may be obtained by providing aquestionnaire over the web portal. Patients may access the web portaland fill the questionnaire. The questionnaire may be accessed throughuser name and password which may be provided by the healthcare platformto the patient. Further, the questionnaire may include interview basedsubjective questions. The patient may also be asked to write his answersin free form as to what he feels. The questions in the questionnaire mayalso be provided in the form of multiple choices. Further, thehealthcare platform may provide incentives to the patients to fill thequestionnaire and provide the clinical outcomes. The incentives mayinclude providing discounts on filling the medical prescriptions.Further, the discounts may be provided over self health testingequipments. The self health testing equipments may include equipmentsfor measuring blood glucose level. The self health testing equipment mayalso include blood pressure measuring equipment. The healthcare platformmay further provide incentives for interaction over patient portals thatare healthcare related online web applications allowing patients tointeract with their doctors, physicians.

The clinical outcome data may also be collected from diagnosis basednews groups. These news groups may be online web applications where thepatients or participants may seek advice about the treatment ormedication from other patients or participants who may have alreadyexperienced a similar kind problem. The clinical outcome data from suchnews groups may be collected by the healthcare platform by automaticscanning of keywords. In an example, the keywords may include terms of aparticular medication, a particular diagnosis or treatment or any typeof clinical outcome. Further, these keywords may be weighted differentlyby the healthcare platform.

The clinical outcome data may further be collected by conducting regularvisits of patient or participant at the doctor's office. In other cases,the clinical outcome data may be collected from the patient's house. Themedical administration data associated with the patient may be collectedfrom the patient's house. Further, the nurses may visit the patient'sresidence to collect vitals associated with the patient and later obtainthe clinical outcomes with the help of these vitals. The vitalsassociated with the patient may include body temperature, pulse rate (orheart rate), blood pressure, and respiratory rate. The clinical outcomedata may further be obtained by visiting offices of medical specialists.The medical specialists may include Ophthalmologist, EndocrinologistGastroenterologist, Gynecologist, Hematologist, Laryngologist,Cardiologist, Neurologist, Orthopedic surgeon, Oncologist, Pathologist,Pediatrician, Dermatologist, Radiologist, Rheumatologist and othermedical specialists.

The clinical outcome data may further be collected by visiting emergencyrooms of hospitals. The condition or the state of the patient in theemergency room may be analyzed to obtain the clinical outcome data.

Further, the clinical outcome data may be obtained by diagnosing thepatients in the hospital. The diagnosis may be conducted by providing aquestionnaire to the patients and asking them to answer questionsrelated to their health.

Further, the clinical outcome data may be obtained from hospitals andclinics where the outpatients regularly visit. Such outpatients may beprovided a questionnaire related to the treatment they are undergoing atthe hospitals and clinics.

Further, the clinical outcome data may be obtained from patients thatare in long term care. The vitals of these patients may be regularlyobtained to analyze the outcome of the drugs. The activity levels ofthese patients may also be monitored regularly to obtain clinicaloutcomes. The outcomes may also be obtained by analyzing the mood of thepatient, the movement of the patients, the type of activity they performand the performance of their tasks.

Another valuable source of clinical outcome data is that collectedbedside at contemporaneous with the administration of medication. Uponadministration of medications at the bedside, the caregiver may beprompted to collect other relevant data. In a preferred embodiment ofthe invention, the data related to outcomes may be collected by theperson administering the medication at the time of administration, andthus may be entered into the HPDMA 100 along with the medicationadministration data. Therefore, the HPDMA 100 may include means forprompting the care giver to enter this information at the time ofadministration.

Because HPDMA 100 provides for the real time tracking of medicationadministration data plus the contemporaneous collection of outcomesrelated to the medication, the outcome engine has the ability todetermine the efficacy of a drug—in effect, potentially providing theability to conduct ad hoc studies. For example, 6000 patients withcondition A may exist. All 6000 of them are on drug X. 3000 of them areon drug X for condition A and drug Y for another condition. The 3000 onboth drugs may fare better with respect to condition A. The methods andsystems described herein allow one to extract such information and seeconnections that might have not otherwise been seen. In another example,some patients taking drug D may stop taking a medication before the fullprescribed amount is consumed because symptoms rapidly improve, whereasothers do not find improvement until the full course is administered.Using the method and systems of the HPDMA 100 as described herein toanalyze the full enhanced electronic health records of these two classesof patients, statistically relevant factors among the classes ofpatients that may support the symptom improvement findings may bedetected.

In embodiments of the invention, the event outcome analytics facility124 may track the event outcomes that may be triggered from the variousfacilities depicted in FIG. 1. These tracked event outcomes may becollected in real time to be utilized by different computer applicationsto provide various types of outputs. In embodiments of the invention,the different types of outputs may include, without any limitations, (1)predictions of treatment or clinical outcomes, (2) predictions aboutcosts of patient recovery or recuperation, (3) grading or ratings forhealthcare facilities, healthcare professionals, medicationeffectiveness, and patient acceptance, (4) reimbursements provided bythe insurance companies for different types of medications, and (5)customized clinical trials databases.

The outcome analytics facility 124 may collect data in real time fromvarious sources and facilities. In an embodiment of the system, theoutcome analytics facility 124 may collect the events outcome from amiddleware facility. The middleware facility may be a part of thethree-tier architecture which may be provided by the healthcare andpharmacy data management and administration 100. In the three-tierarchitecture the presentation, the application processing, and the datamanagement may be logically separated to each other. The middlewarefacility may allow the various facilities, depicted in FIG. 1, toservice data requests between a user and a database. In embodiments ofthe invention, the database may be associated with the E-EHR/E-EMRfacility 118 or may be a third party database. Further, the database maybe accessed by the dashboard facility 150 to present different types ofreports to the user. The access of the database may also be required bythe outcome analytics facility 124 to provide predictions related to theoutcomes.

Further in embodiments of the invention, the healthcare and pharmacydata management and administration 100 may allow the ordering of thecollected data and the structuring of the collected data into variousmedical databases. In an embodiment of the invention, the structuring ofthe collected data may be based on the different types of events. Thedifferent types of events may be related to the prescribing facilities,the care planning facilities, the laboratories & imaging centers, theinsurance & payments, the rehabilitation and long term care facilities,the electronic medical record repositories, the dashboards anddatabases, the third party sites, the healthcare facilities, and thelike. In another embodiment of the invention, the structuring of thecollected data may be based on the diagnosis details of the one or morepatients. In an example, the event outcome data collected for a group ofpatients diagnosed with the same disease may be structured together in adatabase. In yet another embodiment of the invention, the structuring ofthe collected data may be based on the treatment provided to the one ormore patients. In yet another embodiment of the invention, thestructuring of the collected data may be based on the nature of theoutcomes. In yet another embodiment of the invention, the structuring ofthe collected data may be based on the demographics of the patients. Inexamples the demographics of the patients may include their date ofbirth, gender, birth year, country, postal code, ethnicity, blood type,family doctor, insurance provider and the like.

Further in embodiments of the invention, the outcome analytics facility124 may perform a real time tracking of the outcomes associated with theprescribing events and the pharmacy fill events.

In embodiments, once the event outcome data associated with the variousfacilities is collected, the collected data may be utilized by differentcomputer application facilities to provide various types of outputs.Alternatively, the computer application facilities may utilize the datafrom the E-EHR/E-EMR facility 118 to provide various types of outputs.In an embodiment of the invention, the computer application facilitiesmay utilize the collected event outcome data to provide predictedoutcome data.

In another embodiment of the invention, the computer applicationfacilities may utilize the collected event outcome data to predict costsof a patient recovery or recuperation. The costs of the patient recoveryor recuperation may directly relate to various parameters like, but notlimited to, the cost of administering a particular medication to thepatient, the reimbursements provided by the insurance companies for thatmedication, the cost of long term care provided by the health carefacility, the cost of rehabilitation centers provided by the health carefacility, the cost involved in various types of laboratory tests, thecost of admission in the healthcare facility and the like. Further, thecollected event outcome data, from different facilities (depicted inFIG. 1) and other sources, may relate to all these discussed parameters.The computer application facilities may thus apply, known in the art,prediction and financial algorithms on the collected event outcome datato predict the cost of patient recovery.

In other embodiments of the invention, the computer applicationfacilities may utilize the collected event outcome data to grade orprovide ratings to facilities provided by the healthcare facility,healthcare professionals, medication effectiveness, and patientacceptance.

The effectiveness of a medication may be measured in terms of itsclinical outcomes. For example, equal number of dosages of differentmedications, administered to a patient for a disease, may yielddifferent clinical outcomes. Thus, the medication that may yield betterand desirable clinical outcomes with less number of dosages may beconsidered effective. A medication may also be considered effective ifthe medication is able to cure more than one disease. The effectivenessof a medication may also be measured in monetary terms by analyzing theeconomical perspective of the medication. For example, there may be morethan one effective medication that may be used to treat a set ofdiagnosed symptoms; one of these may be more expensive than the otherbut equally effective with regard to alleviating symptoms of thepatient. In this scenario, the financial value may determine theselection of the medicine and the medication with less cost may beconsidered more effective. Further, the collected event outcome data maycorrespond to effectiveness of different types of medications. Thecomputer application facilities may apply, known in the art, correlationalgorithms to rate or grade the effectiveness of the medications.

The collected event outcome data may also provide information about thepatient's acceptances to various types of medications, treatments andfacilities. The acceptances to different types of medications andtreatments may be measured by the clinical or treatment outcomes. Theacceptances to different facilities (e.g. LTC and rehabilitation) of ahealthcare facility may be measured by the checking the number ofpatients opting for those facilities. Further, the computer applicationfacilities may apply, known in the art, algorithms to rate or grade theacceptances patients to various types of medications, treatments andfacilities. In an embodiment of the invention, the information about theratings of the facilities provided by the healthcare facility, theratings of the healthcare professionals, the ratings of medicationeffectiveness, and the ratings of patient acceptances may be sold to apublication company for publishing the information in the articles ofjournals related to medical science.

In other embodiments of the invention, the computer applicationfacilities may utilize the collected event outcome data to providecustomized clinical trials database.

In an embodiment of the invention, the database storing the collectedevent outcome data may be linked to a website of the healthcare facilityto provide non confidential information including, but not limited to,ratings of healthcare professionals associated with the healthcarefacility, medication effectiveness administered by the healthcarefacility, patient acceptance to administered medications and facilitiesprovided by the healthcare facility. The website of the healthcarefacility may provide information about the amount of reimbursementsprovided by insurance companies to the administered medications,facilities used and the like. In an example, a user or a potentialpatient of the healthcare facility may visit the website provide by thehealthcare facility to check the reimbursements provided by insurancecompanies for certain medications that are administered by the healthcare facility. As the website is linked to the database of collectedevent outcome data, the website upon applying some known in the artalgorithms may provide the reimbursement details to the user. Further,the website may provide an updated information to the user as the datais event outcome data is tracked, collected and updated in real time.

The HPDMA 100 may include connecting in real-time a diversity of datacollection, storage, entry, display, management, and maintenancesystems. Each of these systems may have unique data rules, formats,needs, and the like that may make sharing healthcare related data amongthem challenging. One option for dealing with these challenges is toimplement software or software-based computing systems that can operatebetween the diverse facilities and databases forming a middleware thatfacilitates consistently sharing data. Middleware may support dataformat transformation, form filling, data field compliance checking,business rules normalization, and the like that may allow data fromdiverse systems to be shared and combined with high quality results.Middleware may be embodied as software that executes on computers, suchas servers, clients, hosts, network appliances, medical devices, and thelike to allow data that may be natively captured, entered, or stored bya computer associated with a particular facility (e.g. medicationadministration) to be shared with other facilities (e.g. as shown inFIG. 1) without requiring the two facilities to have identical dataformats, business rules, and the like. Middleware may be a combinationof software and hardware that may be integrated with any facilitydepicted in FIG. 1 or that may be a self-standing system that isconnected to the backbone 103, or various combinations thereof.

A couple of exemplary cases may be helpful in understanding howmiddleware may facilitate data sharing among the facilities depicted inFIG. 1. In a first example, data from a laboratory facility (e.g.mammography imaging lab) may include device specific or industrystandard image data, patient data, automated analysis data, technicianobservations, radiologist interpretation data, and the like. This datamay be combined with mediation administration data that may be capturedpartially from a device reader, from a caregiver administering themedication, and from a prescription management facility based on thedevice reader captured data to be stored in an enhanced electronichealth record. Ensuring that data from these many sources can beeffectively combined into one enhanced electronic health record that canbe used by other facilities (e.g. dashboards, outcome analytics, variousplanning facilities, and the like) may be accomplished with middleware.In a second example, raw barcode data that may be captured by a handheld scanner during a medication administration event may be transferredin real-time to a pharmacy management dashboard for display to apharmacist. The raw barcode may be transformed by middleware so that itcan be properly displayed in the dashboard. Because the raw barcode datamay require further context to be properly displayed in the dashboard,middleware may use the raw barcode data to lookup patient information inan enhanced electronic health record database, combine the patientinformation with transformed medication data (e.g. from the raw barcodedata) and facilitate presenting the combined data to the pharmacydashboard.

The middleware methods and systems of the HPDMA 100 may be used totransform data received from the diversity of facilities to a commonformat based on pre-defined criteria for use in a common datastore (e.g.an enhanced electronic health record). Middleware may alternativelytransform manually entered data into machine-readable format. Middlewaremay also support structural association of data, filtering of data, andthe like.

The middleware facility may include processes that may facilitatestorage of data in the common datastore. In this aspect, the data may benormalized before being stored in the datastore. The normalization mayfacilitate reducing redundancy of data, ensuring data consistency,optimizing data retrieval from a common data store, and the like. In anexample, the patient data may be normalized by allocating a uniquepatient identification number for all of a patient's data stored in thecommon data store. The normalization may require that the unique patientidentifiers associated with each of the diversity of medical facilitiesbe transformed by the middleware to the unique patient identifier

Middleware may ensure that data is cleaned before storing it into acommon database. Cleaning of data may be accomplished by filtering thedata, breaking up complex data into uniform data fields, and the like.In an example, a delimiter character may be present in data beingreceived from a patient attribute facility and the delimiter may beremoved by the middleware before the data is recorded in the database.Alternatively, data received from a prescribing facility may includebrand name data for a prescription. Middleware may support filing in ageneric medication field of an enhanced electronic health record basedon the brand name found in the prescription.

Middleware may be embodied in technologies such as SOAP, web services,service-oriented architecture or other similar technologies.

Middleware may facilitate distributing a common datastore, such as anenhanced electronic health record across various medical-relatedfacilities (e.g. those depicted in FIG. 1) by handling the data formattransformation, correlation, lookups, and the like needed to ensure thatany view of the distributed data exhibits consistency across the datasources. Likewise, middleware may facilitate communication among thefacilities through secure means, such as virtual private networks andother network tunneling techniques that work cooperatively withfirewalls and the like.

Healthcare planning, also called Care Planning, is a key to improvingthe health of the population of a region, a country, and the like. Inmost countries, healthcare planning and management takes place atnational, regional or local level reflecting various tiers of governmentfor healthcare systems. Healthcare planning may include offering varioushealth facilities to citizens of a country. Healthcare planning may beprovided and/or maintained by many entities such as governmental,non-profit, and private entities. For example, healthcare organizationssuch as hospitals can provide comprehensive medical facility planningservices to people. Healthcare planning may include various plans inaccordance with the requirement of people. For example, a family healthplan will be aimed at the full family while a group employee benefitplan will be an employee welfare oriented plan established or maintainedby an employer or by an employee's organization. In addition, a healthplan may be a subscription-based medical care arrangement offered bycommercial insurance companies.

Efficient healthcare planning may require defining appropriate goals andobjectives that may further facilitate the creation of appropriatestrategies for implementing the same.

The data requirements to achieve the objectives and goals for a careplan may be driven by a number of factors and/or macro forces such asdemography, role of government, environmental shift, social set up,healthcare innovation and competition, regulations, and the like. Thismay be apparent by way of a few examples that are described below.

Healthcare planning may be aimed at improving the physical andfunctional status of the public health based on the health status anddisease profiles for a given demography or region. Therefore, access totimely, accurate, comprehensive, and diverse medically-related eventdata may be important for healthcare planning. For example, reduction ofcommunicable disease profiles in a Sub-Saharan region may be anobjective for a healthcare entity that may be more readily achieved withreal-time data for patients and others in the region. Similarly, theobjective of healthcare planning may be to meet the high levels ofhealthcare reforms promised by the government. In such a scenario,measuring health care quality, actions, results (outcomes), and the likeis essential to ensure that reform goals are met. The methods andsystems described herein may provide data for such healthcare planningactivities.

It is also known that diseases are linked to climate changes. In lightof this, the healthcare planning goal may be to decrease medical planutilization for environmentally borne diseases such as malaria. Bycollecting bed-side data and associating it with medical plan data,movement toward such a goal may be measurable. With respect tohealthcare innovations and regulations, the objectives of care planningmay be to make the most effective branded drugs readily available andaffordable for those who demonstrate a need for such drugs. Bycollecting and analyzing medication prescription, administration, andoutcome data, the methods and systems herein may facilitate determiningan efficacy of medications. In sum, the data needs of care planning mayencompass data related to prevention and control of health problems,judicious planning, optimization, and utilization of healthcareresources, and the like.

Care planning may require health data from various sources that may beuseful in planning patient treatment. This data may relate tophysiological, emotional, and environmental wellbeing of an individual.For this purpose, medical history of a patient may be utilized. Examplesof physiological health data may include weight, age, blood pressure,glucose levels, blood cells count, hemoglobin levels, hypertension,cholesterol, stroke, pre-clampsia, diabetes, allergy, seizures, asthma,and the like. Similarly, emotional well being data may includeinformation on stress levels, lifestyle patterns, relationship issues,EQ quotients, any special needs, and the like. Further, examples ofenvironmental well being may include information on exposure topollution, neighborhood conditions, food supply, and the like. Thesetypes of data may be readily available to care planning activities byaccessing an enhanced electronic health record as described herein.

The healthcare plans may be offered to individuals or customers based ontheir needs that may be ascertained from profile information or medicalhistory. This also forms the basis of developing goal-orientedhealthcare plans. For example, an over-weight patient may be offered aweight reduction health plan for achieving a desired weight. Similarly,a person with high systolic blood pressure may be offered a healthprogram that may include exercise regime for controlling the bloodpressure, and the like. Not only can an enhanced electronic healthrecord capture patient conditions and changes, it can also include plandata (e.g. weight goals, and the like) that makes the further assessmentof a patient's progress and predicting the outcome for treatments towardthe goal possible.

Care planning may be designed for specific needs of various individuals.The healthcare needs for women, children, elderly, professionals,defense personnel, and the like may differ significantly from eachother. For example, for women a health plan focused on maintainingadequate bone density or maintaining hormonal balance may be requiredand specifically for pregnant women the health plan may be focused onoverall nourishment. Likewise, healthcare needs of children aged 2-8 maybe different from those of teenagers. For professionals with hecticworking hours, a plan that leverages the exercise and diet routine maybe preferred. Similarly, for the elderly or defense personnel a specificweight or glucose level goal may be the focus of a health plan. Ensuringthat healthcare planning can encompass these very diverse goals andneeds may require access to a diversity of data from a diversity ofmedical facilities, such as those described in FIG. 1 of the presentinvention. The HPDMA 100 as described herein may provide the means andcapabilities to support achieving diverse care planning goals.

Care planning may be designed based on patient touch points such asoffice visits, emergency room visits (ERs), inpatient and outpatientquarters, rehabilitation centers, and the like. For example, data for acare plan for an emergency room may be intensive and focused and mayrequire real-time data collection, access, and dashboarding.Multidisciplinary teams of experts may be deployed in the ER areas tomeet the variety of patient needs. In addition, with real-time access toadministration and outcome data for a plurality of patients, detailed,individualized care plans may be developed for an emergency department.

Similarly, a care plan for a rehabilitation center may focus on a numberof parameters such as background needs of the patient, medical equipmentneeds, home healthcare environment needs, nutrition, supply,commodities, education & training, and the like, all of which may bedetermined from outcome and treatment data of a wide diversity ofrehabilitation center patients across the country. Such data may beaccessible in a nationally maintained enhanced electronic health recordsystem as described in FIG. 1.

Also, the needs of inpatients and outpatients may be different,emphasizing the need for different care plans for both of them.Inpatients may require nutritional and daily care (temporary) supportsuch as bathing or dressing while outpatients may prefer a short queuingtime for medications and check-up.

Maternity wards may also require a well designed care planning. Forexample, requirement for a hygienic and separate ward for newborns andthose with special needs.

Insurance processing is a method of collectively pooling the risks ofinsurance payouts across a diverse population. Specifically forhealthcare, risk for incurring medical and health expenses may be pooledamong the various entities (patients, insurance companies, healthprofessionals, etc.) Healthcare insurance processing may include variousdata-related steps such as data collection, data validation, insuranceclaims processing, insurance clearance, payments, expense justification,recovery analysis, and the like. The methods and systems describedherein may provide such data in real-time and over a long period of timefrom a diversity of patients.

Data collection may be a highly significant step in the insuranceprocess. This may include collection of information pertaining to avariety of data such as medical history of a patient, current diagnosis,treatment prescribed, therapist/surgeon/medical specialist information,follow-up treatment, frequency and duration of treatment,amount/mode/process of payment, and the like.

The medical history of a patient may include information from physicalexamination of a patient for various elements such as general survey,skin, head, eyes, ears, nose & sinus, mouth, throat, neck, chest, tumorgrowth, lungs, heart, abdomen, extremities, lymphatic blood vessels,neurological, and the like. The medical history may also includeinformation on previous diagnoses, consultations, and examination byphysicians or medical practitioners. The medical history may also revealif the patient has utilized any diagnostic, therapeutic (surgical or nonsurgical), and rehabilitation services in the past. An enhancedelectronic health record may combine current and past medical treatmentand outcome data for an individual across geographic locations,insurance plans, life changes, and the like.

Current diagnosis information may include various possibilitiesregarding the state of the current disease and symptoms. For example, ifa patient is admitted to a hospital with complaints of severe pain inthe pelvic region, a likely diagnosis in this case may be ‘possibleendometriosis.’ Based on this indicative information, the insuranceprocessing may be conducted. By providing access to data representingsymptoms, treatment, and outcomes of such a diagnosis across a largenumber of patients, the HPDMA 100 may be found to be useful indetermining the monetary range for insurance claims that may be requiredfor relevant treatment options.

Information on medical practitioner, specialist, surgeon, and physicianmay also be significant for insurance processing. Because the chargesand or expenses related to a medical treatment may depend on the medicalpractitioner, knowing something about the efficacy of a practitioner intreating a specific condition may influence how much an insurancecompany may be willing to pay for the practitioner's services. Byallowing access to certain information across a wide range of patients,the HDPMA 100 may facilitate such efficacy determination.

Similarly, information regarding mode of payment such as cash or credit,onetime or periodic may be useful for insurance processing. In case thepayment mode is credit-based, the issuing bank information (name,location, policies) may be of importance for insurance parties. While itmay be preferable to limit access to financial information that isassociated with a patient, the enhanced electronic health record asdescribed herein may facilitate making this information securelyaccessible and readily linkable to other information in the record thatmay be pertinent to insurance processing.

Further, insurance processing may also include information regarding thepayment/co-payment, and reimbursement options. By ensuring thatmedication administration data is automatically and accuratelycollected, it may be possible to collect data to support reimbursementof out of pocket costs for unused medications.

A well planned and well designed facility may provide long term benefitto a healthcare organization. This may also be significant with respectto the organization's objectives such as financial productivity, meetingdemand for services and changes in technology for healthcare, optimalutilization of already existing healthcare resources, and the like.Healthcare providers and planners may utilize healthcare data fordevising solutions for facility planning and space programming forhealthcare services.

Healthcare data for facility planning may be related to the mix ratio ofinpatient and outpatient services, older and critically sick patientpopulation, treatment patterns, advancement in technology, health datarelated to diseases and conditions (asthma, cholesterol, diabetes, heartdisease, hypertension, obesity, etc.), type of healthcare (ambulatoryservices, ER visits, etc.), data related to injuries (accidents,suicides, homicides, etc.), life stages and population (births, deaths,women's health, children's health, state and territorial distribution,etc.), lifestyle (drug use, smoking, exercise, etc.), and the like. Eachof these data fields and their role in healthcare facility planning willbe discussed in detail in the following description.

In accordance with various embodiments of the present invention,healthcare data may be an aggregated or composite healthcare data. Thehealthcare data may be obtained from public sources such as statisticspublished by government agencies, research groups, and web engines orfrom secondary sources such as medical history or profile information ofpatients visiting a healthcare facility.

The mix ratio of inpatient and outpatient services may be a factor forfacility planning. For example, a higher number of outpatient servicesmay be an indicator of an additional outpatient ward. Similarly, anincreasingly high number of older patient populations may call fordesign of facilities that reduce waiting time during admission anddischarge, provision of wheelchairs, canes, elevators, provision ofchemist shops within the facility, long term care units, and the like.

The advancement in technology for example, digital imaging technologymay affect facility design and planning for a healthcare unit such as adiagnostic and interventional radiology facility or laboratory.Conventionally, film-based imaging departments constituted dark rooms,large file rooms, large central technical work area, and a minimalpreparation and recovery area. Current advancements in technologyrequire highly specialized and advanced telecommunicationsinfrastructure capable of rapid transmission of large data files toworkstations throughout the hospital, physicians' offices in thecommunity and even consulting radiologists halfway around the world.Facility design may require consideration of all such factors.

Data (public or secondary) regarding the diseases and conditions mayalso be pertinent for facility planning and management. Increased numberof cases reported for asthma and obesity may lead to designing offacilities that are dust free and equipped with exercise apparatus,respectively.

A high number of emergency room visits may indicate a need for designingthe ERs and trauma centers such that the amount of time taken to carrythe injured to these facilities may be minimized. These facilities maybe designed near a small helipad within the healthcare unit (ifpossible) for catering to emergency situations such as disaster (fire,accident, earthquake, etc.)

Similarly, information pertaining to injuries may be useful inintegrating the main healthcare facilities with some additionalfacilities. For example, if the statistics indicate high number ofsuicide cases in a given region, centers for preventive treatment (yoga,alternate medicine, meditation, community centers, etc.) may be providedwith a hospital.

Various life stages and population statistics (birth and mortalityrates, gender statistics, etc.) may be useful for facility design. Forexample, an increase in the number of children's health records in acommunity may indicate a need for planning a child friendly healthcarecenter in that community. Likewise, a disproportionate male-female childratio in a developing country may indicate need for a community centerthat may act as an awareness camp for the masses.

A long term care center or a facility may provide rehabilitative,restorative, and/or ongoing skilled nursing care to patients orresidents in need of assistance with activities of daily living. Thisfacility planning may require specific consideration and design than thefacility planning for a general healthcare center since it may cater tothe needs of a specific group (e.g., elderly or homeless) that areotherwise not able to get focused healthcare and attention. Examples oflong-term care facilities may include nursing homes, rehabilitationfacilities, inpatient behavioral health facilities, long-term chroniccare hospitals, and the like. Long term care facilities may be designedto make them safe, functional, durable and relatively easy to maintain.Some parameters to be considered while designing the long term carefacilities may include design, layout, ambience, color management,dining and food management, online and kiosk-based layouts, and thelike. For example, the facilities may be designed to include automaticID scanners for residents using the dining facility.

Facility operations may be planned by collecting aggregated content fromEnhanced Electronic Health Records (E-EHR as described herein) of thepatients in a healthcare center or hospital. The E-EHR data maycorrespond to information regarding inpatients, outpatient, staff,administrators, and the like. Based on these records facility layout maybe planned. For example, a yoga center or gymnasium may be provided inclose vicinity of the hospital for the benefit of the healthcareprofessionals working in shifts or emergency areas and who are not ableto attend the same due to unpredictable job demands.

Facility planning may also be related to medication supply management. Aseparate section or layout may be designed for provision of medicinesand other health related equipments and aids such as belts, bandages,syringes, etc.

In accordance with an embodiment of the present invention, thesemedicine counters may also be self-help desk counters or online kiosks.Provision of such medication centers may facilitate smooth work flow forpatients, administrators, guardians, etc., may be effective due toreduction in time between diagnosis and administration of medicines, andmay be cost effective. In addition, it may also reduce the problemsassociated with non-availability of certain medications outside thehospital premises. Determining how and when to effect a medicationsupply facility (e.g. prescription management, medication inventorymanagement, packaging, dispensing and the like) may require accurate andtimely data collection about the prescriptions, a prescriber, patients,medications prescribed, outcomes, and the like being served by thefacility and by other facilities. The methods and systems describedherein in association with the HPDMA 100 may provide such capabilities.

Further, these counters furnished with cost effective drugs may minimizeillegal sale of drugs. For example, Tamiflu for swine flu may be sold atthe hospital counters at lower price, thus encouraging people not to buythe same illegally from outside stores. In addition, this may help thegovernment and health agencies in maintaining proper supply and demandfor emergency medications by discouraging stocking of these medicationsoutside.

Facility planning may also involve scheduling of various tasks andresources in a healthcare unit. Scheduling may include schedulingpatients for appointments, diagnosis, surgery, tests, consultation;rooms for admission, clean-up, administration, operations; healthcareprofessionals and specialists for meetings, visits; and the like. Byproviding access to prescription management data, that may includeadministration information such as administration schedules,requirements, and the like, a facility planning function operating inconjunction with the HPDMA 100 may substantially improve the value andefficiency of such facility planning.

Scheduling may be performed manually or automatically with the aid ofsoftware and tools. This activity may be pertinent since some of thetasks may be period specific. For example, radiation treatments may beprovided only on weekdays and not on weekends, thereby, necessitatingthe need for scheduling the appointment of the patients with thetherapists from Monday to Friday.

In addition, scheduling may be significant to accommodate anyalterations or revisions in the pre-decided schedule; for example,accommodating absence of one specialist by another on any given day.

Furthermore, scheduling may be important for some activities that may besequential in nature. For example, scheduling a steam bath after atherapeutic massage session. This type of scheduling may facilitateoptimization of given resources for an organization. In sum, facilityplanning may require consideration of availability of given resourcesand to address requirements for handicaps like inability to climbstaircase, visual impairment, special washroom facilities, etc.

The HPDMA 100 may also be associated with insurance planning facilitiesas depicted in FIG. 1. Insurance may be provided by government-sponsoredsocial insurance programs or from private insurance companies and it maybe applicable to an individual or to a group. An objective of theinsurance planning is to ensure adequate medical coverage is provided toprotect the covered groups or individuals from unexpected healthcareexpenses by payment of premiums or taxes.

Insurance planning may use information provided by the variousfacilities of the HPDMA 100 and in particular E-EHRs 118, outcomedatabases 124, and the like to make adjustments in available plans basedon the suitability of such insurance plans based for an individual. Planparameters that may be impacted by insurance planning may includecustomary fees, exclusions, maximum out-of-pocket expenses,non-cancellation cases, premium, and the like.

The accessibility of a large number of enhanced electronic healthrecords in an E-EHR database may facilitate establishing a genericprofile of patients and their caretakers for insurance planning. Forexample, insurance planning using the generic profile may result in anew insurance plan being offered to individuals with a high risk jobprofile.

Pharmaceutical or pharmacy planning is another area that may benefitfrom access to various data from the facilities and data sources of theHPDMA 100, such as for devising pharmaceutical related decisions. Thesedata source may include medical history data from the care planning orvalidation diagnosis aspect of the HPDMA 1000, laboratories and imagingfacilities, rehabilitation facilities, databases of past medical records(e.g. E-EHR), third party data sources, and the like.

In certain cases, market driven research may be required for making apharmacy related decision. The data from market research may relate tomarketplace environment, treatment choices available, providers andpatients profile, behavioral patterns, and the like. At least a portionof such data may be derived from pertinent information accessible in anE-EHR.

A data source such as outcome data (e.g. outcome database 124) mayreveal that patients suffer from a side effect e.g., stomach infectionafter taking a particular medication. In light of this observation,planning may be done regarding changing the prescription instructions.In extension to this, pharmacy-related planning may also includedevising methods and processes to make this possible side-effect andadministration information public, such as by means of improving productpackaging broadcasting through print and electronic media, and the like.Alternately, pharmacy planning may include development of a medicationthat is easier to digest or development of a medication that maysuppress the side effects of the previous drug.

Drug delivery mechanism may also be significant with regard to pharmacyplanning. By analyzing outcome data, it may be determined that aparticular oral drug formulation may not be preferred by consumersbecause of its bitter taste so planning may be done to prepare the drugin inhalable form.

Regulatory and compliance needs may be a cause of concern for healthcareprofessionals since these regulations may directly affect anorganization's profitability and business success. Accurate,comprehensive data collection may be essential to properly complyingwith regulatory requirements. By providing robust, detailed, timely, andcomprehensive data collection, medication tracking, administrationrecord keeping, and the like, the HPDMA 100 may provide individualsresponsible for meeting regulatory requirements with beneficial toolsthat ease such compliance. Planning and decision making based on thisinformation may be improved with respect to improving and meetingcompliance, addressing existing deficiencies in the processes, reducingbusiness risks, and the like.

Collection of regulatory data may be necessary and significant for thecontinuous monitoring and reassessment of a drug's safety, quality, andefficacy/effectiveness. The HPDMA 100 may provide a platform forensuring compliant data collection and management.

The methods and systems described in connection with facilitiesdescribed herein, and the operational control of the dispensing machineor any component of a facility described herein (the “Subject Methodsand Systems”) may be deployed in part or in whole through a machine thatexecutes computer software, program codes, and/or instructions on aprocessor. The Subject Methods and Systems invention may be implementedas a method on the machine, as a system or apparatus as part of or inrelation to the machine, or as a computer program product embodied in acomputer readable medium executing on one or more of the machines. Theprocessor may be part of a server, client, network infrastructure,mobile computing platform, stationary computing platform, or othercomputing platform. A processor may be any kind of computational orprocessing device capable of executing program instructions, codes,binary instructions and the like. The processor may be or include asignal processor, digital processor, embedded processor, microprocessoror any variant such as a co-processor (math co-processor, graphicco-processor, communication co-processor and the like) and the like thatmay directly or indirectly facilitate execution of program code orprogram instructions stored thereon. In addition, the processor mayenable execution of multiple programs, threads, and codes. The threadsmay be executed simultaneously to enhance the performance of theprocessor and to facilitate simultaneous operations of the application.By way of implementation, methods, program codes, program instructionsand the like described herein may be implemented in one or more thread.The thread may spawn other threads that may have assigned prioritiesassociated with them; the processor may execute these threads based onpriority or any other order based on instructions provided in theprogram code. The processor, or any machine utilizing one, may includememory that stores methods, codes, instructions and programs asdescribed herein and elsewhere. The processor may access a storagemedium through an interface that may store methods, codes, andinstructions as described herein and elsewhere. The storage mediumassociated with the processor for storing methods, programs, codes,program instructions or other type of instructions capable of beingexecuted by the computing or processing device may include but may notbe limited to one or more of a CD-ROM, DVD, memory, hard disk, flashdrive, RAM, ROM, cache and the like.

A processor may include one or more cores that may enhance speed andperformance of a multiprocessor. The process may be a dual coreprocessor, quad core processors, other chip-level multiprocessor and thelike that combine two or more independent cores (called a die).

The Subject Methods and Systems described herein may be deployed in partor in whole through a machine that executes computer software on aserver, client, firewall, gateway, hub, router, or other such computerand/or networking hardware. The software program may be associated witha server that may include a file server, print server, domain server,internet server, intranet server and other variants such as secondaryserver, host server, distributed server and the like. The server mayinclude one or more of memories, processors, computer readable media,storage media, ports (physical and virtual), communication devices, andinterfaces capable of accessing other servers, clients, machines, anddevices through a wired or a wireless medium, and the like. The methods,programs or codes as described herein and elsewhere may be executed bythe server. In addition, other devices required for execution of methodsas described in this application may be considered as a part of theinfrastructure associated with the server.

The server may provide an interface to other devices including, withoutlimitation, clients, other servers, printers, database servers, printservers, file servers, communication servers, distributed servers andthe like. Additionally, this coupling and/or connection may facilitateremote execution of program across the network. The networking of someor all of these devices may facilitate parallel processing of a programor method at one or more location without deviating from the scope ofthe invention. In addition, any of the devices attached to the serverthrough an interface may include at least one storage medium capable ofstoring methods, programs, code and/or instructions. A centralrepository may provide program instructions to be executed on differentdevices. In this implementation, the remote repository may act as astorage medium for program code, instructions, and programs.

If the Subject Methods and Systems are embodied in a software program,the software program may be associated with a client that may include afile client, print client, domain client, internet client, intranetclient and other variants such as secondary client, host client,distributed client and the like. The client may include one or more ofmemories, processors, computer readable media, storage media, ports(physical and virtual), communication devices, and interfaces capable ofaccessing other clients, servers, machines, and devices through a wiredor a wireless medium, and the like. The methods, programs or codes asdescribed herein and elsewhere may be executed by the client. Inaddition, other devices required for execution of methods as describedin this application may be considered as a part of the infrastructureassociated with the client.

The client may provide an interface to other devices including, withoutlimitation, servers, other clients, printers, database servers, printservers, file servers, communication servers, distributed servers andthe like. Additionally, this coupling and/or connection may facilitateremote execution of program across the network. The networking of someor all of these devices may facilitate parallel processing of a programor method at one or more location without deviating from the scope ofthe invention. In addition, any of the devices attached to the clientthrough an interface may include at least one storage medium capable ofstoring methods, programs, applications, code and/or instructions. Acentral repository may provide program instructions to be executed ondifferent devices. In this implementation, the remote repository may actas a storage medium for program code, instructions, and programs.

The Subject Methods and Systems described herein may be deployed in partor in whole through network infrastructures. The network infrastructuremay include elements such as computing devices, servers, routers, hubs,firewalls, clients, personal computers, communication devices, routingdevices and other active and passive devices, modules and/or componentsas known in the art. The computing and/or non-computing device(s)associated with the network infrastructure may include, apart from othercomponents, a storage medium such as flash memory, buffer, stack, RAM,ROM and the like. The processes, methods, program codes, instructionsdescribed herein and elsewhere may be executed by one or more of thenetwork infrastructural elements.

The methods, program codes, and instructions pertaining to the SubjectMethods and Systems described herein and elsewhere may be implemented ona cellular network having multiple cells. The cellular network mayeither be frequency division multiple access (FOMA) network or codedivision multiple access (COMA) network. The cellular network mayinclude mobile devices, cell sites, base stations, repeaters, antennas,towers, and the like. The cell network may be a GSM, GPRS, 3G, EVOO,mesh, or other networks types.

The methods, program codes, and instructions pertaining to the SubjectMethods and Systems described herein and elsewhere may be implemented onor through mobile devices. The mobile devices may include navigationdevices, cell phones, mobile phones, mobile personal digital assistants,laptops, palmtops, notebooks, pagers, electronic books readers, musicplayers and the like. These devices may include, apart from othercomponents, a storage medium such as a flash memory, buffer, RAM, ROMand one or more computing devices. The computing devices associated withmobile devices may be enabled to execute program codes, methods, andinstructions stored thereon. Alternatively, the mobile devices may beconfigured to execute instructions in collaboration with other devices.The mobile devices may communicate with base stations interfaced withservers and configured to execute program codes. The mobile devices maycommunicate on a peer to peer network, mesh network, or othercommunications network. The program code may be stored on the storagemedium associated with the server and executed by a computing deviceembedded within the server. The base station may include a computingdevice and a storage medium. The storage device may store program codesand instructions executed by the computing devices associated with thebase station.

The computer software, program codes, and/or instructions pertaining tothe Subject Methods and Systems may be stored and/or accessed on machinereadable media that may include: computer components, devices, andrecording media that retain digital data used for computing for someinterval of time; semiconductor storage known as random access memory(RAM); mass storage typically for more permanent storage, such asoptical discs, forms of magnetic storage like hard disks, tapes, drums,cards and other types; processor registers, cache memory, volatilememory, non-volatile memory; optical storage such as CD, DVD; removablemedia such as flash memory (e.g. USB sticks or keys), floppy disks,magnetic tape, paper tape, punch cards, standalone RAM disks, Zipdrives, removable mass storage, off-line, and the like; other computermemory such as dynamic memory, static memory, read/write storage,mutable storage, read only, random access, sequential access, locationaddressable, file addressable, content addressable, network attachedstorage, storage area network, bar codes, magnetic ink, and the like.

The Subject Methods and Systems described herein may transform physicaland/or or intangible items from one state to another. The methods andsystems described herein may also transform data representing physicaland/or intangible items from one state to another.

The elements described and depicted herein, including in flow charts andblock diagrams throughout the figures, imply logical boundaries betweenthe elements. However, according to software or hardware engineeringpractices, the depicted elements and the functions thereof may beimplemented on machines through computer executable media having aprocessor capable of executing program instructions stored thereon as amonolithic software structure, as standalone software modules, or asmodules that employ external routines, code, services, and so forth, orany combination of these, and all such implementations may be within thescope of the present disclosure. Examples of such machines may include,but may not be limited to, personal digital assistants, laptops,personal computers, mobile phones, other handheld computing devices,medical equipment, wired or wireless communication devices, transducers,chips, calculators, satellites, tablet PCs, electronic books, gadgets,electronic devices, devices having artificial intelligence, computingdevices, networking equipments, servers, routers and the like.Furthermore, the elements depicted in the flow chart and block diagramsor any other logical component may be implemented on a machine capableof executing program instructions. Thus, while the foregoing drawingsand descriptions set forth functional aspects of the disclosed systems,no particular arrangement of software for implementing these functionalaspects should be inferred from these descriptions unless explicitlystated or otherwise clear from the context. Similarly, it will beappreciated that the various steps identified and described above may bevaried, and that the order of steps may be adapted to particularapplications of the techniques disclosed herein. All such variations andmodifications are intended to fall within the scope of this disclosure.As such, the depiction and/or description of an order for various stepsshould not be understood to require a particular order of execution forthose steps, unless required by a particular application, or explicitlystated or otherwise clear from the context.

The Subject Methods and Systems, and steps associated therewith, may berealized in hardware, software or any combination of hardware andsoftware suitable for a particular application. The hardware may includea general purpose computer and/or dedicated computing device or specificcomputing device or particular aspect or component of a specificcomputing device. The processes may be realized in one or moremicroprocessors, microcontrollers, embedded⋅ microcontrollers,programmable digital signal processors or other programmable device,along with internal and/or external memory. The processes may also, orinstead, be embodied in an application specific integrated circuit, aprogrammable gate array, programmable array logic, or any other deviceor combination of devices that may be configured to process electronicsignals. It will further be appreciated that one or more of theprocesses may be realized as a computer executable code capable of beingexecuted on a machine readable medium.

The computer executable code may be created using a structuredprogramming language such as C, an object oriented programming languagesuch as C++, or any other high-level or low-level programming language(including assembly languages, hardware description languages, anddatabase programming languages and technologies) that may be stored,compiled or interpreted to run on one of the above devices, as well asheterogeneous combinations of processors, processor architectures, orcombinations of different hardware and software, or any other machinecapable of executing program instructions.

Thus, in one aspect, each method described above in connection with theSubject Systems and Methods and combinations thereof may be embodied incomputer executable code that, when executing on one or more computingdevices, performs the steps thereof. In another aspect, the methods maybe embodied in systems that perform the steps thereof, and may bedistributed across devices in a number of ways, or all of thefunctionality may be integrated into a dedicated, standalone device orother hardware. In another aspect, the means for performing the stepsassociated with the processes described above may include any of thehardware and/or software described above. All such permutations andcombinations are intended to fall within the scope of the presentdisclosure.

While the invention has been disclosed in connection with the preferredembodiments shown and described in detail, various modifications andimprovements thereon will become readily apparent to those skilled inthe art. Accordingly, the spirit and scope of the present invention isnot to be limited by the foregoing examples, but is to be understood inthe broadest sense allowable bylaw.

All documents referenced herein are hereby incorporated by reference.

We claim:
 1. A system for automatically establishing an enhancedelectronic heath record for a patient, comprising: an automatic datacollection facility for collecting data of a medically-related event inproximity to a patient upon the occurrence of the event, wherein thedata of the medically-related event comprises medication administrationdata; and a real-time data integration facility in electroniccommunication with the automatic data collection facility forautomatically integrating the data of a medically-related event with apatient's electronic health record to establish the enhanced electronichealth record.
 2. The system of claim 1, wherein the automatic datacollection facility is a machine reader.
 3. The system of claim 2,wherein the machine reader is a bar code reader.
 4. The system of claim1, wherein the system further comprises an input facility adapted toprompt a user to input additional data of the medically-related event.5. The system of claim 1, wherein the medication administration dataincludes at least one of medication, time of administration, dosage, andreaction data.
 6. The system of claim 1, wherein the enhanced electronichealth record includes prescription management data for a medicationthat is identifiable by the medication administration data.
 7. Thesystem of claim 1, wherein the enhanced electronic health recordincludes data representing a prescription for the medication andmedication delivery data.
 8. The system of claim 1, wherein the enhancedelectronic health record includes data representing caregiver treatmentoutcome data.
 9. The system of claim 1, wherein the enhanced electronichealth record includes data representing real-time collected vitals preand post administration.
 10. The system of claim 1, wherein the enhancedelectronic health record includes data representing outcome predictionand variance from prediction.
 11. The system of claim 1, wherein theenhanced electronic health record includes data representing historicaldata.
 12. The system of claim 1, wherein the enhanced electronic healthrecord includes data representing facility admission data.
 13. Thesystem of claim 1, where medication administration data includesadministration of a dosage of medication.
 14. The system of claim 1,wherein the data collection facility is a reader device in electroniccommunication with a medication administration facility and wherein thereader reads electronically readable information on a packaging of adosage of medication.
 15. The system of claim 1, further including ahealthcare related dashboard that is updated in real-time andcontemporaneously with establishing the enhanced electronic healthrecord. 16.-86. (canceled)
 87. A system for maintaining a healthinformation dashboard, comprising: an automatic data collection facilityfor collecting data of a medically-related event in proximity to apatient upon the occurrence of the event, wherein the data of themedically-related event comprises medication administration data; areal-time data integration facility in electronic communication with theautomatic data collection facility for automatically integrating thedata of a medically-related event into a data repository; and a userinterface for displaying data from the data repository, the displayeddata facilitating management of health care administration.
 88. Thesystem of claim 87, wherein the data from the data repository is patientattribute data.
 89. The system of claim 88, wherein the patientattribute data comprises at least one of: health condition data, patientphysical activity data, patient treatment data, patient outcome data andpatient psychological data.
 90. The system of claim 87, wherein the datafrom the data repository is the patient's prescription data.
 91. Thesystem of claim 87, wherein the data from the data repository is thepatient's validated prescription data.
 92. The system of claim 87,wherein the data from the data repository is the patient's prescriptionhistory data.
 93. The system of claim 87, wherein the data from the datarepository is the patient's prescription substitution data.
 94. Thesystem of claim 87, wherein the data from the data repository relates totime of medication administration.
 95. The system of claim 87, whereinthe data from the data repository relates to frequency of administrationof the medication.
 96. The system of claim 87, wherein the data from thedata repository relates to dosage of medication administered to thepatient.
 97. The system of claim 87, wherein the data from the datarepository relates to medication that was prescribed but notadministered.
 98. The system of claim 87, wherein the data from the datarepository relates to outcome data.
 99. The system of claim 87, whereinthe outcome data is at least one of: patient's response to medicationadministration, measure of the patient's health condition, improvementor worsening of the patient's health condition, improvement or worseningof a symptom, onset of new symptoms, degree of pain, degree of fatigue,physical functioning, emotional distress and social role participation.100. The system of claim 87, wherein management of health careadministration comprises management of health care administration of afacility.
 101. The system of claim 87, wherein management of health careadministration comprises management of health care administration ofcare planning for a patient.
 102. The system of claim 87, whereinmanagement of health care administration comprises management of healthcare administration of care planning for a plurality of patients. 103.The system of claim 87, wherein management of health care administrationcomprises management of health care administration of facility planning.104. The system of claim 87, wherein management of health careadministration comprises management of health care administration ofinsurance planning.
 105. The system of claim 87, wherein management ofhealth care administration comprises management of health careadministration of prescription writing.
 106. The system of claim 87,wherein management of health care administration comprises management ofhealth care administration of prescription management.
 107. The systemof claim 87, wherein management of health care administration comprisesmanagement of health care administration of pharma-related planning.108. The system of claim 87, wherein management of health careadministration comprises management of health care administration ofregulatory compliance.
 109. The system of claim 87, wherein managementof health care administration comprises management of health careadministration of use of third-party healthcare data managementfacilities.
 110. The system of claim 87, wherein management of healthcare administration comprises management of health care administrationof medication administration.
 111. The system of claim 87, wherein thedata repository is an enhanced electronic health record of a patient.112. The system of claim 87, wherein the user interface display isupdated with the data of a medically-related event contemporaneouslywith integrating the data of a medically-related event into a datarepository.
 113. The system of claim 87, wherein the user interface ispopulated contemporaneously with capture of patient attributes andevents. 114.-120. (canceled)
 121. A system for predicting ahealth-related outcome of a patient with a health condition, comprising:an automatic data collection facility for collecting data of amedically-related event in proximity to a patient upon the occurrence ofthe event, wherein data of the medically-related event comprisesautomatically collected medication administration data and outcome data;a real-time data integration facility in electronic communication withthe automatic data collection facility for automatically integrating thedata of a medically-related event into a data repository; and aprediction facility in electronic communication with the data repositoryutilizing the data of a medically-related event for predicting thehealth-related outcome.
 122. The system of claim 121, wherein theoutcome data is the patient's response to the medication.
 123. Thesystem of claim 121, wherein the outcome data is a measure of thepatient's health condition.
 124. The system of claim 121, wherein theoutcome data relates to at least one of an improvement or worsening ofthe patient's health condition.
 125. The system of claim 121, whereinthe outcome data relates to at least one of an improvement or worseningof a symptom associated with the patient's health condition.
 126. Thesystem of claim 121, wherein the outcome data relates to onset of newsymptoms associated with the patient's health condition.
 127. The systemof claim 121, wherein the outcome data relates to degree of painassociated with the patient.
 128. The system of claim 121, wherein theoutcome data relates to degree of fatigue associated with the patient.129. The system of claim 121, wherein the outcome data relate tophysical functioning associated with the patient.
 130. The system ofclaim 121, wherein the outcome data relate to emotional distressassociated with the patient.
 131. The system of claim 121, wherein theoutcome data relate to social role participation associated with thepatient.
 132. The system of claim 121, wherein the automatic datacollection collects data from a medication container contemporaneouslywith the medically-related event.
 133. The system of claim 121, whereinthe data of a medically-related event includes data for a medicationthat was prescribed but not administered during the occurrence of theevent.
 134. The system of claim 121, wherein the outcome data is thepatient's response to the medication.
 135. The system of claim 121,wherein the outcome data is a measure of the patient's health condition.136. The system of claim 121, wherein the outcome data relates to atleast one of an improvement or worsening of the patient's healthcondition.
 137. The system of claim 121, further comprising an inputfacility to enter other data of the medically-related event.
 138. Thesystem of claim 137, wherein the other data comprises patient healthcondition data patient.
 139. The system of claim 137, wherein the otherdata comprises physical activity data.
 140. The system of claim 137,wherein the other data comprises patient treatment data.
 141. The systemof claim 137, wherein the other data comprises patient oral consumptiondata.
 142. The system of claim 137, wherein the other data comprisespatient visitor data.
 143. The system of claim 137, wherein the otherdata comprises patient psychological data.
 144. The system of claim 137,wherein the other data comprises caregiver observations.
 145. The systemof claim 121, wherein the data repository is an enhanced electronichealth record of the patient.
 146. The system of claim 121, whereinpredicting the health-related outcome is based on medically-relatedevent data for a plurality of patients in the data repository.
 147. Thesystem of claim 146, wherein the data repository includes a plurality ofreal-time electronically updated patient enhanced electronic healthrecords.
 148. The system of claim 121, wherein the prediction facilityis for collecting and organizing the outcome data for facilitatingclinical outcome prediction.
 149. The system of claim 121, wherein thedata repository includes individual patient outcome data collected inreal-time from a plurality of individual patients.
 150. The system ofclaim 121, wherein the prediction facility is server executing machinelearning software.
 151. The system of claim 121, wherein the predictionfacility is an analytic workbench for drawing inferences as to whethercertain data in the data repository has statistical significance in theoutcome data.
 152. The system of claim 121, wherein the predictionfacility uses statistical analysis techniques selected from the listcontaining regression analysis, iterative analysis, complex modeling,multivariable analytics, Analysis of Variance (ANOVA), Chi-square test,Correlation, Factor analysis, Mann-Whitney U, Mean square weighteddeviation (MSWD), Pearson product-moment correlation coefficient,Regression analysis, Spearman's rank correlation coefficient, Student'st-test, Time series analysis, Bootstrap & Jackknife Resampling,Statistical classification, Statistical surveys, Structured dataanalysis (statistics), Survival analysis, Multivariate discriminantanalysis, Linear discriminant analysis, Cluster analysis and Principalcomponent analysis.
 153. The system of claim 121, wherein predicting thehealth-related outcome includes weighting the outcome data.
 154. Thesystem of claim 153, wherein weighting the outcome data is based onfinancial data associated with a medication identifiable by themedication administration data.
 155. The system of claim 121, whereinfurther including maintaining a long term care plan for the patientbased on the predicted health-related outcome.
 156. The system of claim121, wherein further including facilitating prescription managementbased on the predicted health-related outcome.
 157. The system of claim121, wherein further including updating prescription management businessrules based on the predicted health-related outcome.
 158. The system ofclaim 121, wherein further including updating a pharmaceutical-relatedplan based on the predicted health-related outcome.
 159. The system ofclaim 121, wherein further including facilitating management ofregulatory compliance based on the predicted health-related outcome.160. The system of claim 121, wherein further including facilitatingprescription writing based on the predicted health-related outcome. 161.The system of claim 121, wherein further including facilitatingmanagement of insurance planning based on the predicted health-relatedoutcome.
 162. The system of claim 121, wherein further includingfacilitating management of facility planning based on the predictedhealth-related outcome.
 163. The system of claim 121, wherein furtherincluding facilitating management of care planning for a plurality ofpatients based on the predicted health-related outcome.
 164. The systemof claim 121 wherein further including facilitating health careadministration for a facility based on the predicted health-relatedoutcome.
 165. A method for predicting a health-related outcome of apatient with a health condition, comprising: collecting data of amedically-related event with an automatic data collection facility inproximity to a patient upon the occurrence of the event, wherein thedata of the medically-related event comprises automatically collectedmedication administration data and event outcome data; integrating inreal-time the data of the medically-related event automatically into adata repository; and utilizing the data of the medically-related eventfor predicting the health-related outcome.
 166. The method of claim 165,wherein collecting data of a medically-related event includes collectingdata from a medication container contemporaneously with themedically-related event.
 167. The method of claim 165, wherein the dataof a medically-related event includes data for a medication that wasprescribed but not administered during the occurrence of the event. 168.The method of claim 165, wherein the outcome data is the patient'sresponse to the medication.
 169. The method of claim 165, wherein theoutcome data is a measure of the patient's health condition.
 170. Themethod of claim 165, wherein the outcome data relates to at least one ofan improvement or worsening of the patient's health condition.
 171. Amethod for predicting a health-related outcome of a patient with ahealth condition, comprising: collecting data of a medically-relatedevent with an automatic data collection facility in proximity to apatient upon the occurrence of the event, wherein the data of themedically-related event comprises raw medication administration data andraw event outcome data; transforming with a processor the raw medicationadministration data and raw event outcome data collected by theautomatic data collection facility into a format suitable for use in amedical information data repository; integrating in real-time the dataof the medically-related event automatically into the data repository;and utilizing the data of the medically-related event for predicting thehealth-related outcome. 172.-191. (canceled)